0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Patient Page |

Postoperative Infections FREE

Janet M. Torpy, MD, Writer; Alison E. Burke, MA, Illustrator; Richard M. Glass, MD, Editor
JAMA. 2010;303(24):2544. doi:10.1001/jama.303.24.2544.
Text Size: A A A
Published online

Infections after surgical procedures (operations) can cause pain, poor wound healing, need for further treatment including antibiotics, longer hospital stays, and increased health care costs. Postoperative infections may cause severe problems, including failure of the surgical procedure, other surgical complications, sepsis, organ failure, and even death. Some persons are at higher risk of developing postoperative infections than others. Ways to try to prevent these types of infections include giving antibiotics before a procedure, when appropriate; making sure the patient is in the best condition possible before elective surgery; using an antiseptic solution to "prep" the area around a surgical incision; maintaining sterility (no bacteria or other organisms, such as viruses or parasites) of the surgical area (also called the "surgical field") and operating tools; and having operating room staff wear clean scrub clothes, hats, and masks. The June 23/30, 2010, issue of JAMA contains an article evaluating measures designed to reduce the risk of infections that occur after surgical procedures.

RISK FACTORS FOR POSTOPERATIVE INFECTION

  • Diabetes

  • Obesity

  • Older age

  • Emergency operations

  • Obvious contamination (with debris, pus, stool, or other substances) of the injury or the surgical area

TREATMENT

  • Antibiotics are given, sometimes by mouth but often through an intravenous line (an IV) for serious infections. In many cases, cultures of the affected area are taken to see if resistant bacteria (which do not respond to the usual antibiotic treatment) are involved.

  • Reexploration of a surgical incision may be necessary to drain pus, an abscess (a collection of infected fluid), or a hematoma (an area of blood and blood clot that can also become infected).

  • If hardware is involved (such as plates, screws, or total joint replacements), and the infection is serious, the metal parts may need to be removed.

  • Supportive care, including fluids, medications to lower a fever, and pain medication, is often needed. If the infection is severe, a person may require staying in the hospital or even in the intensive care unit (ICU) for treatment.

PREVENTING POSTOPERATIVE INFECTION

A national effort to reduce postoperative infections, sponsored by many organizations involved in surgical patient care and health care quality, the Surgical Care Improvement Program (SCIP) was launched in July 2006. Several steps were recommended, and some extra steps were added later, to help prevent surgically related infections. These include appropriate choice of preoperative antibiotics, proper timing and duration of antibiotic dosing, clipping of hair (instead of shaving) around a surgical incision site, keeping appropriate blood sugar levels for persons with diabetes (especially for individuals having heart surgery), and keeping patients having colon surgery at a normal body temperature.

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on quality of care was published in the October 22/29, 2008, issue; one on MRSA infections was published in the October 17, 2007, issue; one on inappropriate use of antibiotics was published in the August 19, 2009, issue; and one on intensive care units was published in the March 25, 2009, issue.

Sources: World Health Organization; Centers for Disease Control and Prevention; American College of Surgeons; American Society of Anesthesiologists; Surgical Care Improvement Project; The Joint Commission; Agency for Healthcare Research and Quality

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

TOPIC: INFECTIONS

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Spanish Patient Pages
Supplemental Content

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles