New guidelines for surgical site infection prevention

 

Around half of all surgical site infections are preventable with proper care

 
January 10, 2018

As a Houston, Texas medical malpractice lawyer, patients and family members frequently hire me to investigate health concerns that began with surgical site infections.

Surgical site infections are those that develop at the location of an incision, cut, or puncture of the skin and underlying tissue made during the surgery.

Types of surgical site infections

The Centers for Disease Control and Prevention (CDC) describes three different types of surgical site infections. The first, a superficial incisional infection, is limited to the area of the skin where an incision was made. The second, a deep incisional infection, spreads to the muscle and tissues below the skin. The third, an organ or space infection, goes even deeper and impacts organs or bodily cavities.

Surgical site infections or serious injuries, have a mortality (death) rate of 3%. Recent research shows that 75% of deaths associated with surgical site infections are directly attributable to the infections.

The most common bacteria causing surgical site infection include Staphylococcus (staph) aureus (20%), coagulase-negative staphylococcus (14%), and enterococcus (12%).

Informed consent does not excuse bad medicine

When we find that these infections were caused by negligence, we file medical malpractice lawsuits against the responsible healthcare providers. In every such case that I can remember, the defendant doctors and hospitals brought up the excuse that the consent paperwork signed by the patient reveals a risk of infection.

I consistently respond to this argument by pointing out that no consent form gives the surgeons, doctors, and nurses permission to provide negligent, substandard healthcare.

Surgical site infections are the most common health care-associated infection, and account for over 30% of hospital acquired injuries. The CDC says that the most recent data reflect an estimated 157,500 surgical site infections associated with inpatient surgeries annually. The CDC has found that around one-half of all surgical site infections are preventable when the healthcare team follows proper strategies and procedures.

The standard of care requires surgeons, doctors, nurses, techs, and other personnel to follow procedures designed to minimize the risk of infection. When healthcare providers skip or bypass these procedures, it can cause an infection.

New guidelines for surgical site infection prevention

In 2017, the CDC released new guidelines—for the first time in almost 2 decades—for the prevention of surgical site infection. These guidelines define the standard of care for surgeons, physicians, and other healthcare providers.

The new guidelines are rather sweeping and many applied to all types of surgery. Some of the significant ones include the following:

Patients should have a perioperative blood glucose target of less than 200 mg/dL (regardless of diabetes status).

Patients should have an anti-septic/antimicrobial soap or plain soap shower, at a minimum, at least the night before surgery.

The patient’s skin should be prepared before surgery with an alcohol-based antiseptic solution.

The surgical team should maintain a normal body temperature (normothermia) for the patient during the operation.

Doctors should order an increased fraction of inspired oxygen during surgery and after extubation (removal of the breathing tube) for patients with normal lung function who received general anesthesia and endotracheal intubation is a part of the surgery.

In cesarean section cases, the healthcare team should give the mother an anti-microbial prophylaxis medication before skin incision, rather than after the cord is clamped.

We are here to help

If you or a loved one has been seriously injured as a result of a surgical site infection, or any other medical malpractice related injury, call Painter Law Firm, in Houston, Texas, for a free consultation about your potential case.

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Attorney Robert Painter is a former hospital administrator who handles medical negligence and wrongful death lawsuits at Painter Law Firm PLLC, in Houston, Texas.

Robert Painter

Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.

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