Surgical Wound Infections prevention: Non-Pharmacologic Strategies

Surgical wound infections remain a significant and common postoperative complication, detected typically within the first week following surgery. Despite advancements in surgical techniques and sterile practices, these infections persist, underscoring the importance of the body's own defense mechanisms. The role of host defense is particularly crucial during the immediate perioperative period, as this is when the body fights to prevent contaminants from developing into clinical infections.

Importance of Host Defense

Host defense mechanisms, especially in the first few hours after contamination, are vital in reducing the risk of infection. This period is so critical that even interventions limited to the perioperative timeframe can significantly influence infection rates. Factors such as wound perfusion, immune function, and the administration of antibiotics play pivotal roles. However, non-pharmacologic strategies also offer significant benefits, particularly those managed by anesthesiologists.

Maintaining Normothermia

Both general and neuraxial anesthesia impair the body's thermoregulatory control, often leading to hypothermia in unwarmed surgical patients. This mild hypothermia is associated with several severe complications, including increased blood loss, prolonged recovery times, and higher rates of surgical wound infections. Hypothermia can impair immune function and decrease subcutaneous oxygen tension due to vasoconstriction, both of which increase infection risk.

To mitigate these risks, maintaining normothermia during surgery is crucial. Studies have shown that even mild hypothermia can triple the incidence of wound infections following surgeries such as colon resection. Therefore, ensuring patients remain normothermic can substantially reduce infection rates and improve overall surgical outcomes.

Supplemental Oxygen

The immune system's ability to kill bacteria relies heavily on oxidative processes that require sufficient oxygen levels. Increasing the inspired oxygen concentration during and after surgery can enhance tissue oxygenation, thereby boosting the immune response. Research indicates that supplemental oxygen can significantly reduce the risk of surgical wound infections.

For instance, a study involving 500 patients undergoing elective colon resection found that those who received 80% inspired oxygen had half the infection rate compared to those who received 30% oxygen. These findings highlight the importance of adequate oxygenation in preventing postoperative infections.

Additional Non-Pharmacologic Strategies

Besides maintaining normothermia and providing supplemental oxygen, Surgical Wound Infections Prevention other non-pharmacologic strategies can help:

TAHAT offers warming devices designed to prevent hypothermia:

• Patient warming devices. These devices assist in maintaining normothermia throughout all perioperative phases: preoperative, intraoperative, and postoperative.
• Blood and fluid warmers. The delivery of cold infusion solutions and blood can lead to a decrease in core body temperature, contributing to accedental hypothermia. To prevent this and maintain normothermia, fluids are warmed to the required temperature before being delivered to the patient.
• Warming cabinets. These cabinets are used for heating and storing solutions, fluids, and blankets.

Non-pharmacologic measures, particularly those managed by anesthesiologists, play a vital role in surgical wound infections preventing. By maintaining normothermia and optimizing oxygenation, along with other supportive strategies, the risk of postoperative infections can be significantly reduced. These interventions, though simple, have profound implications for improving patient outcomes and reducing healthcare costs associated with surgical infections.

For more detailed information, you can access the full study here.