SSIs, a key problem

“According to a study by Boltz and Hollenbeak, individuals with surgical site infections (SSI) are five times more likely to be readmitted to hospitals. They are also twice as likely to die. Furthermore, surgical site infections result in cost totals ranging between $5 billion and $10 billion per year, without taking into account additional expenses related to factors such as job loss or malpractice litigation. While there are ways for hospital staff and administration to reduce the prevalence of surgical site infections at their respective facilities, they remain a significant problem for many facilities.”

In this article several reasons are mentioned why SSI can occur. The problem may begin with the lack of an effective surgical hand scrub on behalf of the surgical team. “People are starting to not give a good scrub in the morning or perhaps in the afternoon after they eat lunch,” says Wava Truscott, Director of Medical Sciences & Clinical Education for Kimberly-Clark Health Care. “They are getting things under their nails because you just can’t get the alcohol inside your nails. I’m not an advocate of scrubbing every single time, but at least one or two times that day to get all the dead cells and everything off.”

Another problem would be the disinfection quality of surgical rooms, equipments, cloths. Keeping surgical instruments covered until surgery is under way is one key behavior, as is using products that reduce the presence of particulates in the air. Such products include powder-free surgical gloves, low-lint gowns, drapes, wraps, towels, and blankets. “We lose five million skin cells a day, and at least 10 percent have bacteria on them. So it can be quite easy to contaminate a surgical area and not even realize it.”, says Truscott. “[…] Lint can get inside of the wound. Then you get what is called immune distraction. It certainly can carry organisms into the wound itself, and that can contaminate the surgical wound. But just the presence of those particles, the immune system sees those as a much larger threat than the tiny bacteria, that it focuses on the particles instead of the bacteria and allow the bacteria to multiply to the point where you can’t stop the infection.”

According to Tom Stang, Clinical & Education Manager for Key Surgical, a provider of sterile processing supplies, a successful defense against SSI begins in the decontamination area of any central service or central processing department.

“It is where you are going to disinfect and clean these instruments before they even go to the sterilizer,” says Stang. “If they are not clean, they are never going to be sterile.”

He also suggests improper cleaning at bedside is a factor into why surgical site infections are an issue for many facilities. Nurses are working quickly to deal with patients, and in some cases, they just don’t simply have the time to do it effectively or correctly. Furthermore, some hospitals are operating with fewer surgical techs on staff, so nurses have been forced to take on many added responsibilities in the operating room. Adequate staff training, clear expectations, effective policies and procedures, as well as helpful feedback from staff are critical to dealing with some of these issues.


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