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A U G U S T 2 0 1 4 | S U P P L E M E N T T O O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
way when an infection occurs, we're able to confine ourselves to a much small-
er set of variables and improve our chances of zeroing in on the cause.
2. Use pre-operative wipes. We all carry bacteria around on our
skin. We can't eliminate it, but the more we can decrease it, the less chance
there is of introducing it into the surgical site. To minimize the risk, we tell our
patients to use chlorhexidine wipes 24 hours before surgery.
3. Carefully time prophylactic antibiotics. Multiple articles
show that the timing of antibiotics is exceedingly important. Too early and the
effect will have worn off. Too late, and there won't be enough time for it to get
into the patient's system. We have a strict protocol and make sure administra-
tion takes place within 1 hour of surgery for cefazolin and within 2 hours for
vancomycin.
4. Check noses. A certain number of patients carry bacteria in their
noses, and a patient with MRSA in his nose has a much higher chance of getting
an infection. So as part of our protocol, we now swipe everyone's noses before
surgery. If a patient has MRSA, we treat it ahead of time with a dose of antibi-
otics.
5. Warm consistently. It's clear that keeping patients warm before, dur-
ing and after surgery reduces the chance of infection. This is especially important
during longer surgeries — 2 hours or more — which often tend to be more com-
plicated and involve sicker patients. The concern may not be as obvious in outpa-
tient environments, where shorter procedures are the rule, but as more and more
procedures migrate to outpatient settings, it's going to become an increasingly
important point to keep in mind.
P R E V E N T I N G I N F E C T I O N S
