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Test Taking Tip

Familiarize yourself with the table below for wound classification and general indication for antibiotic therapy.


Name factors that influence the development of infection:

  • Poor approximation of tissue, hematoma/seroma, hypothermia, long operation (>2 hours), excessive local tissue destruction/necrotic tissue, low blood flow, foreign body, dead space, and strangulation of tissues by tight sutures

Most common nosocomial infection:

  • Urinary tract infection (UTI)

How many colony-forming units (CFUs) are needed on urine culture to confirm a diagnosis of UTI?

  • >100,000 CFU

Most common nosocomial infection causing death:

  • Pneumonia

Overall most common organism in surgical wound infections:

  • Staphylococcus aureus

Most common anaerobe in surgical wound infections:

  • Bacteroides fragilis

When do wound infection classically arise?

  • Postoperative day 5 to 7

Treatment for a wound infection:

  • Remove sutures/staples, culture wound, examine to rule out fascial dehiscence, leave wound open and pack, start antibiotics

Bacteria that will cause wound infection and fever within 24 hours after surgery:

  • Group A β-hemolytic Streptococcus and Clostridium perfringens

Organisms that can cause necrotizing soft tissue infections:

  • Group A β-hemolytic Streptococcus and Clostridium perfringens

Usual organism to cause necrotizing fasciitis:

  • Polymicrobial (anaerobes with gram-negative organisms)

Time period to wait before obtaining a CT scan to look for postoperative abscess:

  • >POD no. 7 (otherwise abscess may look like normal post-op fluid collection)

Findings on CT scan to indicate abscess:

  • Gas in fluid collection, fibrous ring surrounding fluid collection

Usual initial treatment for intraabdominal abscess:

  • Percutaneous drainage

Most common bacteria to cause a line infection:

  • Staphylococcus epidermidis

How many CFUs are needed from a central line culture to indicate line infection?

  • >15 CFU

In what instance should a central line be changed over a guidewire?

  • Fever without obvious ...

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