tailieunhanh - Gynecologic Surgical Site Infections: Simple Strategies for Prevention

The poor nutritional status of women in developing countries has been associated with maternal mortality. Maternal deaths do not result from malnutrition alone, however, but mainly from a lack of access to obstetric care and from previous conditions that may be aggravated by poor nutrition. For example, maternal deaths caused by obstructed labour are more common in malnourished adolescents and young women with a short stature and small pelvic size; and deaths resulting from haemorrhage during childbirth and the immediate postpartum period may be associated with severe anaemia (Rush 2000). . | FEATURE Gynecologic Surgical Site Infections Simple Strategies for Prevention Christa Lewis DO Patrick Culligan MD FACOG FACS 14 The Female Patient VOL 36 MARCH 2011 With recent emphasis on all aspects of patient safety it is good to be reminded of the basic protocols of surgical site infection prevention. Gynecologic surgical site infections SSIs most commonly arise when bacteria that naturally occur on the skin or vagina contaminate an incision site. Other potential sources of bacteria are skin-to-skin contact with health care workers as well as contaminated medical equipment. Despite widespread use of prophylactic antibiotics SSIs remain a major issue facing the health care system today. Patients who experience SSIs utilize more health care resources such as intravenous antibiotics and clinician care and are at greater risk for readmission All articles are available online at . LEWIS and CULLIGAN and Should you suspect that a patient has an SSI early identification and treatment are critical. Beyond patient care SSIs are a key consideration for an institution s bottom line given the new mandatory reporting requirement for hospitals. They affect up to 500 000 patients per year and result in an annual cost to hospitals of 3 As of October 2008 the Centers for Medicare and Medicaid Services CMS stopped reimbursing for treatment of certain health care-associated conditions including SSIs that have evidence-based prevention guidelines. Also beginning in 2012 CMS is requiring hospitals to use the CDC s National Healthcare Safety Network to report incidences of SSIs in order to receive a full Medicare reimbursement for payments in 2014. These reported infections will become public information providing a forum in which our institutions can be evaluated by prospective patients and professionals. Many ObGyn professionals perceive cesarean delivery as the surgery most likely to result in an SSI yet SSI incidence following .

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