Infection Control in Surgical Practice

Abstract

May 2008

Section Section 1 Basic Surgical and Perioperative Considerations

2 Infection Control in Surgical Practice

Vivian G. Loo, MD, MSc, FRCP(C),
Associate Professor, Department of Medicine, McGill University and Chief, Department of Microbiology, McGill University Health Centre

Surgical patients and medical personnel are at increased risk for nosocomial infections. This chapter discusses infection control in surgical practice; host and operative risk factors; composite risk indices such as the National Nosocomial Infections Surveillance Basic Risk Index and Modified Basic Risk Index; preventive measures, including those related to hand hygiene, sterilization and disinfection, hair removal, and the operating room environment; standard and transmission-based isolation precautions; exposure to bloodborne pathogens such as hepatitis B and C virus, HIV, and tuberculosis; activities of an infection control program, including surveillance, verification and definition of infection, use of denominators, data analysis, reporting, and outbreak investigation; and antimicrobial-resistant microorganisms such as staphylococci, enterococci, and Clostridium difficile. Environmental control, education, and involvement of the Public Health and Community Health Services are described as cornerstones of infection control. The elements of an infection control program are given, including an Infection Control Committee and an Infection Control Service. Tables list the surgical site infections; the physical status scale from the American Society of Anesthesiologists; recommendations from the Centers for Disease Control and Prevention for preventing HIV and hepatitis B virus transmission during invasive procedures; and ACS recommendations for preventing transmission of hepatitis. This chapter contains 94 references.

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