A Patient's Guide to Preventing Surgical Site Infections

• Wounds can get infected by germs from the skin or the environment during or after surgery

• To reduce the risk of infection patients should use the Decolonisation Pack (see separate leaflet) before surgery

• Do not remove hair by shaving prior to surgery as this may cause skin abrasions.

• All patients are screened for Methicillin Resistant Straphyloccus Aureus (MRSA) before or on admission to hospital

• If you are found to have MRSA you will be asked to have a course of treatment before your operation

• Antibiotic medicines are given to some patients to prevent surgical site infections

• All wounds are checked regularly while in hospital for signs of infection

• Staff and patients need to be aware of the importance of washing hands and keeping the wound clean

• At RNOH, we take necessary precautions and care to reduce the risk of wound infections.

Most operations involve making cuts (wounds) in the skin. Most wounds heal without problems, but a wound can become contaminated by germs (bacteria) from the skin or environment that may get into the body and cause an infection.

A wound infection can appear at any time within a few days up to 3-6 weeks after the operation, until the wound has healed. Infection can develop after you leave the hospital and if you have had metalwork put in, signs of infection might appear after several months. At RNOH, you will be monitored for surgical site infection up to a year from your operation.

Signs of a wound infection include:

• redness, swelling and heat around the wound;

• the wound becoming more painful to touch;

• green or yellow pus coming from the wound, which may be smelly;

• edges of any part of the wound have separated or

• you feel generally unwell or feverish, or have a raised temperature.

If the infection is left untreated, it spreads deeper into the body or into the bloodstream and additional symptoms will develop to include a fever and feeling very unwell. You must seek medical advice if you suspect you have a wound infection.

During your stay in hospital, your team will regularly check your wound for any signs of infection. If you are concerned about your wound tell the nurse who is looking after you.

If you have been discharged from the hospital and develop one or more of the symptoms mentioned on page 3, please contact your general practitioner (GP) or attend your local hospital unless you have been told to contact your surgical team here at RNOH. Other options include your local urgent care/walk-in centres.

Patients who have undergone certain operations will be sent a questionnaire after discharge to monitor progress of the wound.

Before your operation

• If you have an infection before your operation, even if it’s only a cold or sore throat, tell the hospital immediately

• If advised, you should use the Decolonisation Pack before your surgery

• You should eat a healthy balanced diet and stay hydrated, and have adequate sleep

• Keep warm before and after surgery as this is important for wound healing

• Do not shave on the operation area before surgery.

After your operation

• If you are given antibiotics, make sure that you take the whole course as instructed

• If any staff come to look at or change your wound dressing, it is crucial that they clean their hands before and after touching it. Please ask them if you have not seen them clean their hands

• Avoid touching your wound or dressing. If you need to, wash your hands properly before doing it

• Inform the ward staff of any issues that you notice with regards to environmental cleanliness

• Rest and sleep are important to wound healing

• Keep the dressing dry as much as possible. At home, if the dressing gets wet during your shower, change the dressing with clean hands.

• Our operating theatres and clinical areas are cleaned to the highest standards

• We have a dedicated Surgical Site Infection (SSI) Surveillance team who monitors infection rates in our patients

• Before an operation starts, the skin area is disinfected and sterile sheets are used to protect the operating area

• The air and environment in the operating area are monitored

• Where necessary, patients are given antibiotics before, during or after surgery to prevent infection

• Every patient is nursed with care to try and avoid germs getting into the wound or any other area, such as a catheter or drain (where a tube is used to drain a wound of excess fluid)

• You will be given warming blankets if necessary prior to surgery to keep you warm.

• Please check with the nursing staff before you visit how many people are allowed to visit at one time and whether children are permitted.

• Please do not come in to visit if you have an infection, including a cold or other minor infection. If you are not sure you should check with the nursing staff first.

• Every visitor should wash their hands or use alcohol gel/rub regularly while on hospital premises.