Perioperative Care; Fluid and Electrolyte

Post-operative Infections

Post-operative infections can be classified by both site and cause. Discussed below are some of the most common causes. Surgical Site Infection (SSI): SSIs can complicate recovery in 5% of patients; risk factors include intra-operative exposure to endogenous organisms (e.g. during bowel surgery), prolonged surgery and impaired immunity (e.g. diabetes, immunosuppression) . Management may require antibiotics, suture removal and debridement with open wound care. Central Venous Catheter Infection: Infection of central venous catheters (CVC) may lead to catheter related blood stream infections (CRBSI) that can have a 25% mortality. CVCs should be reviewed daily and CRBSI should be suspected when there is a CVC and signs of bacteraemia; a positive blood culture and growth of the same organism from the CVC would support the diagnosis. CVC’s should always be removed as soon as they are not needed. Inflammation around the CVC insertion is relatively uncommon and its absence does not rule out CRBSI. Treatment usually requires antibiotics and removal of the line. All CVS’s should be inserted with meticulous aseptic technique: gown, mask, gloves, skin preparation, antibacterial dressing. Urinary tract infection: Urinary catheters are inserted perioperatively to facilitate surgery or to aid fluid balance management. They do, however, predispose patients to urinary tract infections that may need antibiotic treatment.