Wound Healing and Infection Prevention

Wound Healing and Infection Prevention

• Impaired wound healing's most serious consequence is infection.
• Antiseptics and aseptic techniques aim to reduce contamination, making wounds less hospitable to bacteria.
• Knowledge of these techniques is crucial for medical professionals (wards, operating rooms, emergency departments) to prevent infection, complications, and potentially, death.

Definitions

• Aseptic Technique: Preventing microbial contamination of tissues and sterile materials by excluding, removing, or killing microorganisms.
• Disinfection: Killing or removing enough microbes to make an inanimate object safe for its intended purpose.
• Antiseptics: Chemicals applied to living tissues to kill or inhibit microbial growth.
• Cross Infection: Transferring microbes from one hospitalized patient to another.
• Auto Infection: Infection caused by organisms already present on the patient's body or in infected areas.

Ideal Antiseptic Properties

• Broad Spectrum: Effective against a wide range of microbes.
• Resistance to Organic Matter: Unaffected by substances like blood and feces.
• Non-Toxic and Non-Allergic: Safe for use on living tissue.
• Affordable: Cost-effective.

Infection Prevention in Surgical Wounds

• Sources of Infection:
  • Patient
  • Staff (healthy carriers, incubating illness, or with overt illness)
  • Operating room environment
  • Instruments (occasionally)
• Routes of Infection:
  • Direct contact (patient-to-patient, patient-to-staff, staff-to-patient)
  • Airborne transmission

Operating Room Asepsis

• Most surgical wound infections occur during procedures. Thus, strict asepsis is vital.

Staff Asepsis

• Proper attire: Clean clothes, shoes or covers, mask and cap beyond the "green zone"
• Scrubbing: Thorough scrubbing of all surgical team members for at least 5 minutes with antiseptic soap or detergent
• Skin protection: Use brushes to clean under nails only. Dry with sterile towels. Apply 70% alcohol or Povidone iodine (if available).
• Sterile garments: Don sterile gloves and gowns in a sterile manner

Patient Asepsis

• Hair Removal: Shave hair immediately before surgery.
• Surgical Site Preparation:
  • Adults: Clean the surgical site with chlorohexidine and 2.5% iodine.
  • Children: Clean with 70% alcohol.
  • Use povidone iodine for all ages (if available)
• Sterile Drapes: Cover the prepared site with sterile drapes.