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Surgical_Site_Infection_(SSI)

Surgical_Site_Infection_(SSI) - August,2006...

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    Infection in Surgical Patients August, 2006 Mike Joutovsky, PGY3 Department of Surgery St. Barnabas Hospital
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Defense Barriers Physical Chemical Immunologic
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Host defense Barrier Microbial flora Humoral Cellular cytokine
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Microbial flora
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Humoral defenses Immunoglobulin Complement
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Immunoglobulin All Ig classes (IgM, G, A, E, D and igG  subclasses are composed of one type  (M,G,A,E,D) of heavy (H) and one type of  light (L) protein. Each L chain is linked to an H chain, and H  chains are interlinked. H chain activate complement or bind to  receptors of either macrophages or PMN  leucocytes The amino terminus of the H and L chains  together forms antigen-binding site
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Immunoglobulin
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Complement system Series of serum proteins that may  became activated via either classic or  alternative pathway
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Cellular defense Macrophage PMN leucocytes cytokines
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Surgical Site Infection ( SSI )
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Clinical criteria ( CDC ) A purulent exudate draining from the  surgical site A positive fluid culture obtained from a  surgical site that was closed primarily The surgeon’s diagnosis of infection A surgical site that requires reopening
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FACTS One out of every 24 patients who have  inpatient surgery in the United States  has a postoperative SSI The cost of SSIs are substantial: an  increased total cost of more than 300% SSIs increase the post operative length  of hospital stay by 10-14 days
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Definition SSI is a difficult term to define  accurately because it has a wide  spectrum of possible clinical features  “It’s hard to define, but I know it when I  see it.” SSI are classified into three categories,  depending of which anatomic areas are  affected 
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