Prevention

Pre-Operative

• Optimise patient’s medical co-morbidities
  • Tight diabetic control
  • Nutritional status
• Smoking cessation
• Screen for MRSA

Peri-Operative

Patient Preparation

• Shave hair with clippers at the time of surgery
• Perform a pre-wash for non-elective trauma cases
• Skin Preparation
  • Alcoholic 2% chlorhexidine or alcoholic povidone-iodine

Antibiotic Prophylaxis

• For contaminated cases and clean cases with prosthesis insertion
• Administer within 1 hour of incision & prior to tourniquet use (local policy)
• Repeat antibiotic dosage if surgery is prolonged
• Avoid unnecessary use to prevent resistance

Theatre Issues

• Use laminar flow
• Minimise theatre traffic

Hands

• Good hand washing technique
  • Use 2% chlorhexidine or povidone-iodine
  • Remove all jewellery

Drapes & Clothing

• Use disposable drapes
• Wear disposable gowns
• Change clothing on leaving the theatre suite
• Use different shoes for inside and outside the theatre

Surgical Technique and Wound Management

• Perform efficient surgery:
  • Minimal soft tissue damage and skin handling
  • Avoid long tourniquet times
  • Ensure haemostasis to prevent blood loss
  • Use sound wound closure techniques
  • Apply see-through interactive dressings

Anaesthesia

• Maintain steady body temperature to avoid hyperthermia or hypothermia

Post-Operative

• Use ring-fenced beds for elective cases
• Allocate side rooms for infectious patients
• Breed a good ward culture for infection control
• Minimise dressing changes
• Use aseptic technique if dressing changes are necessary
• Apply see-through interactive dressings
• Wash hands between each patient contact
• Treat oozing wounds aggressively
• Avoid unnecessary use of antibiotics