Chapter 5 The prevalence of SSI is a major concern because of the associated increased incidence of morbidity and mortality, length of hospitalization, and cost of care for postoperative patients. Although similar data are not available in veterinary medicine, it has been shown that preventing a single case of SSI caused by a methicillin-resistant Staphylococcus aureus (MRSA) can save human hospitals as much as $60,000 (Anderson et al, 2009). Preventive preoperative measures that can reduce the risk of SSI include administration of antimicrobial prophylaxis (see Chapter 9) and proper utilization of skin antiseptic agents for the surgical team (see Chapter 6) and the patient. In a comprehensive study of 225 matched pairs of human patients with and without SSI, infected patients were twice as likely to die compared with uninfected patients (Kirkland et al, 1999). Thus, it is imperative that veterinarians and their staff be proactive in preventing infection during surgery by using proper techniques and solutions to prepare the skin for surgery. Before the animal is transported to the surgical suite, the incision site is given a general cleansing scrub, and ophthalmic antibiotic ointments or lubricants are placed on the cornea and conjunctiva. Studies suggest that using clean, rather than sterile, supplies for this initial cleansing prep does not influence the infection rate if the skin is intact (Cheng et al, 2001). Lesions, eruptions, abrasions, irritations, rashes, dermatitis, burns, denuded or traumatized areas, or other similar medical conditions that could provide a portal of entry for a pathogen should not be present. In male dogs undergoing abdominal procedures, the prepuce should be flushed with an antiseptic solution (Fig. 5-3). The skin is scrubbed with germicidal soaps to remove debris and reduce bacterial populations. The area is lathered well until all dirt and oils have been removed. This is a generous scrub that often encompasses the hair surrounding the operation site to remove unattached hairs and dander that may be disturbed during draping. FIG 5-3 Flush the prepuce of male dogs with antiseptic solution before performing the sterile preparation.
Preparation of the Operative Site
Treatment of Hair
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Preparation of the Operative Site
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