Protecting yourself, your patients, and staff from nosocomial infections, and in particular from surgical site infections (SSI) is essential to avoid unnecessary suffering, but also to be able to save costs, improve standards of care and prevent contamination. 

About one in 20 patients undergoing surgery will develop a surgical site infection; in addition, the rate of exposure of personnel to the patient’s blood during surgery reaches 10.4 per 100 procedures. It is important to ensure patient safety in the operating room and to protect healthcare workers from infections from blood-borne diseases. 

Indeed, health care workers are often exposed to pathogens. Needlestick injuries, estimated at about one million in Europe every year, put them at risk of contracting blood-borne diseases, including hepatitis B, hepatitis C and HIV. The risk for patients is even higher.  

Consequently, we at AMIL Care think it is important to learn more about SSI surgical site infections. 

Surgical site infections (SSI): what are they?

SSIs are potential complications associated with any type of surgical procedure. In the world, they still have a critical impact on patient mortality and morbidity, and on the additional costs borne by the healthcare system and users. 

SSI is the type of infection most likely to be hospitalized in low- and middle-income countries, which is why SSI prevention has received significant attention from infection control professionals, health authorities, and the media. 

The burden of surgical site infections

As you might guess, surgical site infections are particularly expensive to treat. An example of SSI would be a patient who develops a deep tissue infection, resulting in him being hospitalized for an extended period of time, occupying bed space that could have been used for other patients. 

As Epicenter, the public health epidemiology of the Istituto Superiore di Sanità, explains, several studies have been conducted in Italy since the 1980s to assess the frequency of hospital infections. Based on the ECDC protocol, Italy developed a point prevalence study, conducted on 56 facilities and 14,773 patients distributed in various departments, which took place between October and November 2016. This study showed that the prevalence of patients with at least one SSI was 8.03%. The most frequent infections were respiratory (23.5 percent), bacteremia (18.3 percent), urinary (18 percent), and surgical site (14.4 percent). 

For further information, we refer to the reading of the study prepared by the World Health Organization. 

Surgical site infections or operating room infections: what are they?

We can classify three main surgical site infections: 

  • Surgical site infection is limited to the incision site superficial infection.
  • Surgical site infection is limited to the incision site deep infection.
  • Surgical site infection involving organs and spaces. 

Superficial infections are infections that occur within 30 days of the date of surgery and may only involve the skin or subcutaneous tissue in the incision area. In general, this type of infection can have some symptoms, such as: 

  • purulent discharge from the incision;
  • pain or feeling of tension;
  • localized swelling redness. 

Deep infections occur within 30 days of surgery in the absence of a prosthetic implant, within a year in the presence of a prosthetic implant, and show at least one of the following symptoms: 

  • purulent discharge from deep tissues, but not involving organs or spaces adjacent to the incision;
  • deep incision spontaneously dehiscent or deliberately opened by the surgeon when the patient has at least one of the following signs, i.e., fever greater than 38°, pain and/or localized tension unless the site culture is negative. Abscess or other evidence of infection seen on direct examination, during reoperation, or by radiologic or histopathologic examinations. Diagnosis of profound SSI made by the surgeon or treating physician. 

Surgical site infections: the causes

SSI or operating room infections are caused by microbial contamination of the surgical wound. Microorganisms can penetrate: 

  • From the skin of patients;
  • By surgeons and other operating room personnel;
  • From the air;
  • From contaminated surfaces or tools used during surgery. 

Prevent surgical site infections

Preventing SSI is not easy. For example, it is estimated that about a third of the population naturally carries the Staphylococcus aureus bacterium on their skin and in their nostrils. Some strains of this bacterium, such as methicillin-resistant Staphylococcus aureus or MRSA, are resistant to several antibiotics. Both staphylococci and enterococcal bacteria can survive for days to months after drying on commonly used hospital textiles and plastics. 

Air is also a source of infection: every minute humans lose thousands of “scales” of skin, each potentially carrying bacteria. 

Infections in the operating room: the riskiest procedures 

Surgical site infections are extremely heterogeneous, and the incidence varies according to the type of operation, but also to the conditions of the patient and the hospital environment. They can occur during and after hospitalization and are the second most common type of infection acquired in a hospital setting. 

Most SSIs are acquired in the operating room and result primarily from sources exogenous to the patient, such as contamination of instruments or gloves, but they can also be endogenous in nature when the microorganisms causing them are present on the patients’ own skin or mucous membranes. A significant percentage, about 60%, occurs after patient discharge.  

Medisystem by AMIL Care: a concrete aid to fight surgical site infections

It is thanks to the use of hydrogen peroxide as an active ingredient combined with silver salts and micro-nebulization technology that Medisystem carries out its activity of prevention and fight against hospital infections, including those affecting the surgical site. 

In fact, hydrogen peroxide confirms its effectiveness on microorganisms of all types: bacteria, viruses, spores, fungi, and biofilms. Micro nebulization allows the saturation of the environment by eliminating pathogens through the oxidation of their cell membranes. The hydrogen peroxide then dissolves in water and oxygen, leaving no residue. These features make the system safe and practical to apply. 

Medibios plus.hub, the effective response to SSI

Medibios plus.hub is a Class I CE marked medical device: a latest generation patented micro nebulizer, practical, handy, and technological, designed to be used in various hospital areas. Treatment settings are made via a touchscreen display. 

Medibios plus.hub treats from 10 to 2000 cubic meters of space; allow high-level disinfection cycles with no-touch technology, together with validated protocols, in critical areas and on the main multi-resistant pathogens. The device can connect to pre-set sensors, which allow recognition of the room and the inserted program. Each cycle performed generates a report in PDF format, which can be saved on a USB stick and printed. 

The combination of the Medibios plus.hub with the AMIL Care disinfectant chemicals forms Medisystem.