Test Taking Tip
Familiarize yourself with the following table for wound classifications and general indications 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, advanced age, chronic disease (e.g. COPD, renal failure, liver failure, diabetes mellitus), malnutrition, immunosuppressive drugs, and strangulation of tissues by tight sutures
|Wound Class ||Definition ||Infection Rate |
|Clean ||Nontraumatic, elective wound without acute inflammation ||2% |
|Example: hernia |
|Clean-contaminated ||Wounds associated with operation on biliary, GU tract, or respiratory or GI tract without gross contamination ||3%–5% |
|Example: elective colon resection with bowel prep |
|Contaminated ||Traumatic wound, GI tract spillage, acute inflammation, or a major break in sterile technique ||5%–10% |
|Example: gunshot wound to colon with repair |
|Dirty ||Dirty traumatic wound, perforated viscous, or presence of pus ||30% |
|Example: Abscess |
Most common nosocomial infection:
How many colony-forming units (CFUs) are needed on urine culture to confirm a diagnosis of UTI?
Most common nosocomial infection causing death:
Overall most common organism in surgical wound infections:
Most common anaerobe in surgical wound infections:
When do wound infections classically arise?
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:
Organisms that can cause necrotizing soft tissue infections:
Usual organism to cause necrotizing fasciitis:
Time period to wait before obtaining a CT scan to look for postoperative abscess:
Findings on CT scan to indicate abscess:
Usual initial treatment for intraabdominal abscess:
Most common bacteria to cause a line infection:
How many CFUs are needed from a central line culture to indicate line infection?