Infection Prevention

A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. Some of the common symptoms of a surgical site infection are:

• Redness and pain around the area where you had surgery
• Drainage of cloudy fluid from your surgical wound
• Fever 

• Cleaning their hands and arms up to their elbows with an antiseptic agent just before the surgery.
• Cleaning their hands with soap and water or an alcohol-based hand rub before and after caring for each patient.
• If necessary, removing some of your hair immediately before your surgery using electric clippers if the hair is in the same area where the procedure will occur. They should not shave you with a razor.
• Wearing special hair covers, masks, gowns, and gloves during surgery to keep the surgery area clean.
• Giving you antibiotics before your surgery starts. In most cases, you should get antibiotics within 60 minutes before the surgery starts and the antibiotics should be stopped within 24 hours after surgery.
• Cleaning the skin.
• For select procedures, bathing with a disinfectant solution called chlorhexidine the day before and the morning of surgery.

Before your surgery:

• Tell your doctor about other medical problems you may have. Health problems such as allergies, diabetes and obesity could affect your surgery and your treatment.
• Quit smoking. Patients who smoke get more infections. Talk to your doctor about how you can quit before your surgery.
• Do not shave near where you will have surgery. Shaving with a razor can irritate your skin and make it easier to develop an infection.
• Ask your provider if you need any shots or vaccines
• Bathe with Chlorhexidene prior to coming to the hospital if instructed to.

At the time of your surgery:

• Speak up if someone tries to shave you with a razor before surgery. Ask why you need to be shaved and talk with your surgeon if you have any concerns.
• Ask if you will get antibiotics before surgery.

After your surgery:

• Make sure that your health care providers clean their hands before examining you, either with soap and water or an alcohol-based hand rub.
• Do not allow family and friends who visit touch the surgical wound or dressings.
• Ask family and friends to clean their hands with soap and water or an alcohol-based hand rub before and after visiting you. If you do not see them clean their hands, ask them to clean their hands.

• Acquiring a fever is often the first sign of infection. Other symptoms and signs of an infection after surgery include:
• Increasing swelling and redness of the skin around the incision site.
• Increasing tenderness and pain in the surgical area.
• Increased drainage or pus from the incision site.
• Separation and bleeding of a previously sealed incision.
• If you notice any signs listed above or anything else out of the ordinary, contact your doctor immediately.

A “central line” or “central catheter” is a tube that is placed into a patient’s large vein, usually in the neck, chest, arm or groin. The catheter is often used to draw blood, or to give fluids or medications. It may be left in place for several weeks. A bloodstream infection can occur when bacteria or other germs travel down the “central line” and enter the blood. If you develop a catheter-associated bloodstream infection, you may become ill with fevers and chills or the skin around the catheter may become sore and red.

• Choosing a vein where the catheter can be inserted safely and where the risk for infection is small.
• Cleaning their hands with soap and water or an alcohol-based hand rub before putting in the catheter.
• Wearing a mask, cap, sterile gown and sterile gloves when putting in the catheter to keep it sterile. The patient will be covered with a sterile sheet.
• Cleaning the patient’s skin with an antiseptic cleanser before putting in the catheter.
• Cleaning their hands, wearing gloves and cleaning the catheter opening with an antiseptic solution before using the catheter to draw blood or give medications. Healthcare providers also clean their hands and wear gloves when changing the bandage that covers the area where the catheter enters the skin.
• Deciding every day if the patient still needs to have the catheter. The catheter will be removed as soon as it is no longer needed.
• Carefully handling medications and fluids that are given through the catheter.

• Ask your doctors and nurses to explain why you need the catheter and how long you will have it.
• Ask your doctors and nurses if they will be using all of the prevention methods discussed above.
• Make sure that all doctors and nurses caring for you clean their hands with soap and water or an alcohol-based hand rub before and after caring for you.
• If your bandage comes off or becomes wet or dirty, tell your nurse or doctor immediately.
• Inform your nurse or doctor if the area around your catheter is sore or red.
• Do not let family and friends who visit touch the catheter or the tubing.
• Make sure family and friends clean their hands with soap and water or an alcohol-based hand rub before and after visiting you.

Some patients are sent home from the hospital with a catheter in order to continue their treatment. If you go home with a catheter, your doctors and nurses will explain everything you need to know about taking care of your catheter.

• Make sure you understand how to care for the catheter before leaving the hospital. For example, ask for instructions on showering or bathing with the catheter and how to change the catheter dressing.
• Make sure you know whom to contact if you have questions or problems after you get home.
• Make sure you wash your hands with soap and water or an alcohol-based hand rub before handling your catheter.
• Watch for the signs and symptoms of catheter-associated bloodstream infection, such as soreness or redness at the catheter site or fever, and call your healthcare provider immediately if any occur.