Surgical Site Infections

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A surgical site infection (SSI) is an infection that occurs after surgery in the part of the body where the surgery took place. About 300,000 SSIs occur each year. While most surgeries do not result in infection; about 1-3 patients out of every 100 who have surgery currently develop SSIs. Certain preventable surgical site infections (SSI) will no longer be reimbursed according to the Center for Medicare and Medicaid Services (CMS). Effective October 1, 2008, The Centers for Medicare and Medicaid Services (CMS) selected high-cost or high-frequency events from the National Quality Forum's list of “never events” for inclusion in this reimbursement change (Brown, Doloresco, Mylotte, 2009). Objects left in patients after surgery, certain surgical infections and preventable falls are just a few of the preventable occurrences that will no longer receive reimbursement. Research suggests that there is a correlation between surgical site infections (SSI) and the surgical technique used, for example in relation to skin preparation, shaving and wound closure (CMS, 2012). Skin preparation: The skin is colonised by various types of bacteria, but up to 50% of these are Staphylococcus aureus (Eriksen, et al, 1995). In analyses of contamination rates after cholecystectomy, the main source of wound contamination was found to be the skin of the patient. For this reason, preoperative preparation should be performed. Evidence has shown that the use of a preoperative wash containing chlorhexidine decreases the bacterial count on skin by 80-90%, resulting in a decrease in preoperative wound contamination. The effect on SSI incidence has, however, been more difficult to demonstrate and it is possible that prolonged washing releases organisms from deeper layers of the skin (Byrne, et al, 1991). Shaving: It is now recognized that shaving damages the skin and that the risk of infection

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