Many Americans will face a surgical procedure this year. Despite the improvements for surgery and recovery, all surgeries carry a risk of surgical site infections (SSI).
On another note, the number of ambulatory surgeries continues to increase. Modern improvements allow ambulatory surgery patients to recover in their homes instead of facing hospitalization. However, surgeries performed in an ambulance still carries increased risks of surgical site infections when compared to hospital surgeries.
In fact, according to the most recent statistics published by the Centers for Disease Control (CDC), more than 48 million ambulatory surgical procedures are performed annually. This number is expected to see rapid growth as surgical procedures are increasingly simplified and improved. Such improvements often include the increased use of less invasive techniques, such as laparoscopic and robotic surgery.
Wound health is critical to the healing process in any invasive surgical procedure, no matter how minor. If the skin becomes infected in the area of the surgical wound, the SSI is considered to be superficial. However, when tissues, organs, or implanted materials are infected below skin level, the SSI becomes much more serious.
Recognize the Signs
Patients who have inpatient procedures usually remain hospitalized for some time after their surgery. While hospitalized, these patients stay closely monitored by hospital staff for any signs of surgical site infection. For many surgery patients, monitoring reduces the risk of SSI and other side effects. However, because ambulatory patients typically go home within hours of the procedure, they usually don’t have the benefit of an observation period.
In order to overcome this problem, ambulatory surgical patients must learn to recognize the signs of a developing SSI, including:
- Increased heat, pain, swelling, or discomfort in the area of the surgical wound
- Changes in skin color in the immediate area of the wound, such as a deepening shade of red or a bruised appearance
- Fluid drainage from the wound
Surgical site infections can be present even when visible changes in the wound are not noted. A medical team should immediately evaluate patients who experience either a low-grade fever after surgery. Patients who also show a sudden spike in body temperature in the days after surgery should also be checked on. Patients who experience these symptoms should call their doctor immediately to rule out the possibility of an SSI.
Early detection of SSI symptoms, especially for superficial infections, makes at-home treatment possible. In most cases, this treatment would include a combination of in-home wound care by a visiting professional, careful monitoring by the patient’s medical care team, and a regimen of oral antibiotics to clear the infection.
If the infection involves tissues, organs, or implanted materials within the body, hospitalization may be necessary to safely manage the problem and help speed healing.
When ambulatory surgical patients suffer a surgical site infection and require in-patient treatment, they are usually given intravenous antibiotic treatment. However, surgical site infections that occur below skin level may also require reopening the wound to drain fluid, remove dead tissue, and clean the infection site.
Reduce the Risks
Ambulatory surgical patients can reduce the risk of developing an SSI by performing routine procedures recommended by hospitals and surgical centers. These include:
- Keeping the wound site clean
- Engaging in frequent hand washing and the use of liquid hand sanitizers
- Changing dressings as directed by their medical care team
- Opting to wear sterile gloves when changing dressings or checking the wound
- Taking any prescribed antibiotics as directed
- Attending all scheduled medical care appointments and making sure to alert their surgeon or attending physician whenever a potential problem is noted
Additional Risks and How to Mitigate Them
Smoking slows down most types of wound healing. For this reason, ambulatory surgical patients who smoke must refrain from smoking until their wound has completely healed.
Patients with underlining conditions such as diabetes and obesity stand a higher risk of developing SSI. Furthermore, ambulatory surgical patients who take some types of prescription medications, illegal drugs, or over-the-counter (OTC) supplements and medications, may also be at increased risk for infection.
Notify your surgical team of any preexisting conditions or usage of prescription or OTC medications or supplements before scheduling the procedure. Remember, patients may not qualify for an ambulatory procedure if their surgeons feel they are at an increased risk of developing a surgical site infection or some other complication. Instead, these patients may require inpatient surgery.
In cases where the procedure is elective and not considered time-sensitive, you may be able to work with your surgeon to reduce any risks. You may even qualify for a later ambulatory procedure. You can also reduce the risk by receiving treatment for your risk factors. For example, making efforts to stabilize blood sugar levels, lose weight, or stop certain medications for a period of time before scheduling your procedure. Be sure to talk to your doctor before halting any medications.
Ambulatory surgeries often become the best choice for patients undergoing minor emergency procedures due to their less invasive nature. However, patients should remember that real risks exist for any surgical procedure.
When considering any type of surgery, choose care from an accredited provider with an excellent reputation for putting their patient’s health first. Since 1977, The Surgical Clinic has provided patients throughout Middle Tennessee with expert, patient-focused care. Contact us today to learn more about what we offer and how we can help you and your loved ones.