There are, however, many other ways to reduce the infection rate in surgical patients. In human surgery, such practices have enabled a 25% reduction in nosocomial infections, also called hospital-acquired infections.
Beyond antibiotics, there are a number of ways to prevent infections.
- Oxygenation good oxygenation of the patient allows killing of bacteria via oxidative processes. Preoxygenation and short-term postoperative oxygenation can therefore be beneficial to fight surgical site infection.
- Control body temperatures many studies show that hypothermia is a common cause of infection. Hypothermia causes peripheral vasoconstriction and therefore poor local oxygenation. Hypothermia also decreases the patient's immunity, among other deleterious effects.
- Control blood sugar hyperglycemia can also potentiate infections. Glycemia should therefore be monitored closely, especially in poorly regulated diabetic patients, which are at increased risk of infection.
- Reduce anesthesia time duration of anesthesia is statistically correlated to the infection rate.
- Prevent licking or chewing of surgical incisions using an Elizabethan collar or Bite-Not collar.
- Perform sterile IV catheter placement, conscientious patient clipping (i.e. wide enough) and meticulous scrubbing technique.
- Improve the nutritional status of debilitated patients.
- Have constant awareness of asepsis during scrubbing, gowning, gloving and throughout surgery. Actually wearing a gown, cap and mask happens to be standard protocol, just like actually wearing clothes! wearing booties could be considered optional, if not debatable.
- Convert contaminated wounds into "clean contaminated" or cleaner wounds as soon as possible.
- Avoid elective surgery on immuno-suppressed or immuno-deficient patients.
- Use gentle tissue manipulation and careful tissue apposition to decrease the risk of hematomas or seromas.
- Treat distant infections such as dermatitis, otitis externa or tooth abscesses if possible before elective surgery.
- Change gloves whenever they are contaminated or perforated. The first step is to be honest with yourself.
- Avoid clipping the patient too long before surgery. Microtrauma by the clippers facilitates entry of bacteria into the skin and triples the risk of incisional infection.
- Limit the use propofol, which has been associated with a four-fold increase in surgical site infection.
- Avoid dental prophylaxis on the same day as an elective surgery.
- Meticulously clean the operating room, including the surgical lights and the table. Some veterinarians hide silver dollars in conspicuous places as an incentive!
- Use sharp, good quality, sterile instruments
- Establish a comprehensive plan to prevent nosocomial diseases, starting with frequent hand washing, especially after treating each patient.
- The standard for most elective procedures is to give an intravenous antibiotic such as cefazolin 30 minutes before the skin incision and every 90 minutes under anesthesia.
