Personal injury and medical malpractice attorneys have likely been involved in cases that included a surgical site infection. These infections may be devastating to patients. I can think of several we have seen at Med League. The infections may occur in a variety of ways:

• A woman falls off a toilet in an assisted living facility and rips up her newly replaced knee joint.
• A patient develops an infection in a laminectomy site and develops osteomyelitis in his back.
• A man develops an infection in his sternum after a triple bypass and dies from the infection.

How common are surgical site infections?
In the United States, about 300,000 surgical site infections occur per year, which is 2 to 5 percent of patients undergoing inpatient surgery. Three percent of these patients will die from their infection. Others will develop long-term complications from an infected surgical site.

Where do these bacteria come from?
Some are from the patient’s skin, mouth or gastrointestinal tract. Some bacteria come from an infection within the body. Some of the bacteria comes from the surgical team, in the form of soiled gowns, breaks in sterile technique or inadequate hand hygiene, the operating room and its equipment, or the postoperative care.

How are they treated?
The key to effective treatment of any infection is to determine what organism is involved. While waiting for cultures to return, healthcare providers typically give broad spectrum antibiotics. Then they fine tune the medications based on the sensitivities and resistance data provided with the culture.

How are they prevented?
Here are some best practices that have a high degree of reliability for preventing infection:

• Administer IV antibiotics within 1 hour before making the incision, 2 hours for Vancomycin and fluoroquinolones.
• Identify and treat infections before an elective surgery.
• Do not remove hair at the operative site unless it will interfere with the operation. If hair removal is needed, use clipping or a depilatory agent, not a razor.
• Maintain a warm immediate postoperative room temperature.
• Use appropriate antiseptic agents and techniques for skin preparation.
• Prepare the patient for bowel surgery with enemas or cathartic agents and oral antibiotics.
• Keep the OR doors closed during surgery as much as possible to control traffic.
• After surgery, leave the dressing undisturbed for 24-48 hours.
• Control blood sugar levels immediately after surgery to keep the blood sugar below 200 mg/dl.
• Discontinue antibiotics within 24 hours after surgery end time (48 hours for a person with cardiac problems)
• Practice good hand hygiene when performing dressing changes.

Med League provides medical expert witnesses to trial lawyers. Please call us at (908)788-8227 or contact us today to discuss your next case.