The last thing anyone wants to get when they go to the hospital, especially for an elective surgery or procedure, is an infection! If you are considering having an Orthopedic Procedure such as your knee scoped, hip replaced or ACL repaired, there are things you can do to lower your risk of surgery infection, or Surgical Site Infection (SSI).
Hospital-Acquired Infections are at the top of every hospital administrator and clinicians worry list these days. In 2011, there were an estimated 157,000 reported Surgical Site Infections (ref), but thankfully, that number has decreased significantly in the last five years. This is mostly because there has been tremendous attention devoted to the problem on the health care delivery side of the equation since infections are now being tracked, reported and penalized.
Here are six things that have been shown to make a difference in preventing Surgical Site Infection (SSI) for elective Orthopedic procedures:
- Pick a surgeon and hospital that does a lot of the procedure, ask what their infection rate is and how it compares to the national average. (Check out the ProPublica article on why this is important)
- Make sure you know that an antibiotic is given within 1 hour of the start time (for Orthopedic procedures, it is usually Cafazolin)
- Get tested for Methicillin-Resistant Staph Aureus before the procedure with a nasal swab. If positive, get treated with anti-septic body wash and nasal antibiotic ointment for 5 days. Get re-tested.
- If you have diabetes, make sure your blood sugar is well-controlled before surgery.
- Quit smoking (!)
- Ask that no more than one resident physician (a surgeon still in training) participate in your surgery.
Other factors that predict surgical site infection are less in your control such as:
- Blood loss: the less the better. Requiring a transfusion is a risk for infection.
- Surgery time: more than 2.5 hours is associated with increased risk
- Your overall health: obesity, diabetes, underlying malignancy and rheumatoid disease all predispose you to infection risk.
When we put our life and limb in the hands of a surgeon, we often forego our own responsibilities for the outcome. That is a mistake.
When we put our life and limb in the hands of a surgeon, we often forego our own responsibilities for the outcome. That is a mistake. This list is developed from the Orthopedic literature, but many of the steps apply to any elective surgery. It’s up to all of us to ask questions, and take action to get the care and outcomes we want.