Many of us overuse antibiotics postoperatively, which can lead to side effects, such as vomiting and diarrhea, and antibiotic resistance in out patients.

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.

  1. 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.
  2. 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.
  3. 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.
  4. Reduce anesthesia time duration of anesthesia is statistically correlated to the infection rate.
  5. Prevent licking or chewing of surgical incisions using an Elizabethan collar or Bite-Not collar.
  6. Perform sterile IV catheter placement, conscientious patient clipping (i.e. wide enough) and meticulous scrubbing technique.
  7. Improve the nutritional status of debilitated patients.
  8. 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.
  9. Convert contaminated wounds into "clean contaminated" or cleaner wounds as soon as possible.
  10. Avoid elective surgery on immuno-suppressed or immuno-deficient patients.
  11. Use gentle tissue manipulation and careful tissue apposition to decrease the risk of hematomas or seromas.
  12. Treat distant infections such as dermatitis, otitis externa or tooth abscesses if possible before elective surgery.
  13. Change gloves whenever they are contaminated or perforated. The first step is to be honest with yourself.
  14. 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.
  15. Limit the use propofol, which has been associated with a four-fold increase in surgical site infection.
  16. Avoid dental prophylaxis on the same day as an elective surgery.
  17. Meticulously clean the operating room, including the surgical lights and the table. Some veterinarians hide silver dollars in conspicuous places as an incentive!
  18. Use sharp, good quality, sterile instruments
  19. Establish a comprehensive plan to prevent nosocomial diseases, starting with frequent hand washing, especially after treating each patient.
  20. 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.


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