Diagnosis and Treatment of Surgical Site Infection

[@floatboatthegoat1267]

I’ve said it once and I’ll say it again, you are the King of Surgery… Every medical student on the planet thanks you Doctor🙏❤️

[@citizensurgeon]

That’s so kind, thank you! More on the way!

[@funwithgrace1431]

@@citizensurgeon yes please do. Can't wait to see your new video release.. Thank you so much for good explanation and simplify..

[@citizensurgeon]

@@funwithgrace1431 sweet, have a five part series on wound care coming out, part one…systemic factors in wound care coming out this week

[@funwithgrace1431]

@@citizensurgeon Thank you. Quite amazing you are still able to do some videos in ur busy schedule. If possible, please upload content video of diverticulitis, demonstration of how to do suturing and the correct technique. I am also trying to access your website but unfortunately some contents aren’t accessible.

[@citizensurgeon]

@@funwithgrace1431 thanks Grace, I’ve been working on reconfiguring the website so there have been a few hitches…I’ll definitely get a diverticulitis talk up soon!

[@diannh2894]

You've given me more comfort! My boyfriend got tibia full rod surgery and still has a broken fibula. This helps me feel more confident in checking on his wounds.

[@beccarusso5253]

Im taking anibiotics for an infection 8 days after RNY surgery. Red and painful, but no ozzing and the skin is all healed up. No opening but abx started today. Im nervous but it helps me settle down because science and medicine have come so far, and i can really trust medical professionals ❤

[@deepajoshi2778]

Your initiative and efforts makes surgery easier and interesting....especially the clinical aspect ... Thank you.

[@citizensurgeon]

Thanks so much, I love teaching so I’m happy you’re enjoying the content. More to come :)

[@mohamedsaleh8138]

Brilliant! I'm not only learning but having more fun than one could on Netflix haha. Ty so much, super informative and easy to follow

[@citizensurgeon]

I’m so happy I could help you learn and have fun while doing it!

[@subeyrnour2427]

In my first attachment in surgical ward my Dr gave me this Topic as Reading Assignment after that am watching this wonderfull vedio hopefully this will help me thank u Doctor🙏🙏🙏🙏

[@citizensurgeon]

That is so awesome I’m pumped that you enjoyed it! Good luck on your rotation!

[@poorianasserinia1822]

Thank you very much. These videos have been a great help with my studies. 🙏

[@citizensurgeon]

Love that, thanks so much for the feedback and I’m excited I could be helpful

[@ghettohey2388]

So Im planning to have an elective surgery. Where can I go to find data on surgical site infection rates for the Ambulatory Surgery center Im having do my surgery

[@calcaneus2000]

I would like a video that describes in real practice the different pediatric vs adult osteomyelitis types and treatments.

[@motazalkhawaja2041]

Thank you doctor 🌷, waiting for more ..

[@citizensurgeon]

Absolutely, spread the word, more to come!

[@dr.pharmacistclinical3535]

Great video.. Very informative Wish the best

[@citizensurgeon]

Thanks so much I’m pumped you enjoyed it!

[@TaylorRaine]

Not sure if you will see this, but I have question regarding risk. I am a carrier of c diff and get super sick any time I have to take antibiotics . I am scheduled for surgery next month (lumpectomy) and my dr has agreed to forgo the typical iv antibiotics during surgery. Does this out me at a much greater risk of infection later after the fact? I have none of the risk factors you listed - except that major one about antibiotics . What would you do 😂 Thanks

[@citizensurgeon]

Taylor, appreciate the comment, while I can’t give medical advice I think I can answer your question. For clean cases, for example lumpectomy, under most circumstances antibiotics are not indicated and this does not lead to increased infection risk. Good luck with your surgery!

[@TaylorRaine]

@@citizensurgeon yes! awesome! Thank you for not giving me medical advice but putting my mind at ease :)

[@polkadocz9874]

Excellent video as usual! Thank you for your efforts. These videos have been very helpful and a great tool for learning.

[@renadktn]

Beautifully explained! Thankk youu sooo muchhhh dr. Erik!

[@citizensurgeon]

Thanks so much for the feedback! Glad you enjoyed it! Let me know if there is another topic you’re interested in learning about!

[@dragyemangbadu]

Thanks Doc!🎉❤

[@KarinaSanchez-qi4lo]

I had surgery… glutes reconstruction.. and now I have moderate e-coli in my wound… I have a drain put in 15 days now still draining , yellowish a bit thick liquid coming out… culture of the liquid says e-coli… doctors have no idea how to treat it since it’s in my right glute 😢

[@citizensurgeon]

I'm sorry this happened to you Karina and I apologize for such a delayed reply. I hope you found effective treatment!

[@FalilatOzigiAbubakar-dq1qt]

Good day Dr! I had a breast abscess surgery about 2months ago and it has refuse to heal, it keeps reoccurring under the previously operated place, purse has been removed through procedure twice. I was nursing but had to stop after the procedure. Please I would like to know what to do, I am really worried.

[@citizensurgeon]

Thanks for the question, recurrent wounds are difficult to deal with, while I can’t provide medical advice on this platform I definitely think you should revisit your doctor and see if the wound needs debridement or a different care plan to help it to heal

[@FalilatOzigiAbubakar-dq1qt]

@@citizensurgeon alright, thanks alot

[@colleenpellant1484]

I had a coccygectomy yesterday and was released today. I've already ripped it a bit and have blood at the site.

[@asmaghallab2270]

Wow! Great explanation 👏

[@citizensurgeon]

Awesome, thanks Asma, glad you enjoyed it! Definitely check out the wound classification video as well.

[@hayatmasoud7597]

Is any one have a presentation about ssi?

[@rubysingh3324]

I'm 25, gone through a fibroadenoma surgery on 21th july 2022, after five days one of the stich broke out and pus mixed blood seen, I'm having regular antibiotics and getting the incision dressed every 2nd day, still having blood out, no recovery seen, please explain.

[@citizensurgeon]

Hi Ruby thanks for posting! I’m sorry this is happening, I can’t give any medical guidance on a platform like this but I would certainly contact your surgeon for concerns about a wound infection. Good luck!

[@heatherleclair135]

I just got a breast reduction and the skin has turned bright red on day 9 (there was no red prior to this). I was given Keflex. I have no idea what to expect

[@citizensurgeon]

Thanks for engaging Heather, I can’t give medical advice but it sounds like you’re on the right track and definitely have close follow up with your surgeon if anything changes. Hope you have a swift recovery!

[@PalmtreesGoodvibes]

Please help me Doctor? Im trying to make a long story short.. I fell and eas drugged accross gravel for , when i was walking a dog... I have a WHOLE right below that little bone ,below the knee ..i went to hosp.they.didnt close it or close it and its the tip of my finger deep.( Pretty bad..they only gave me 19 days keflex' ) But i tokall 10days wir6.looked better.2 week later THERES A HUGE BUNLLE ( with blood and puss in it oertryfing oit the wound.!! Im running a fever 101deg.fhnt.its red all around it.i also am 46.nenic.malnutrition epilptic had JRA( ARTHRITIS since 3 yrs old.) im so scared please soneone help ?? God bless you .

[@PalmtreesGoodvibes]

I also have had a Total hip replacement 3 years ago..I'm so scared I'm gonna get deposit. ( If I'm not already).or worse can happen🙏. My y father that's 67 has a diabetic wound that made him septic.hes all the family I have..and he's been in the hospital a Month..please respond to me. I'm so scared and alone.

[@michauxbôts]

"Doctors say they must operate soon, but there's no knowing what they'll find when they open up the wound - I will meet you on the other side of the moon..."

[@citizensurgeon]

A poem of the uncertain...sometimes operating is traveling to the dark side of the moon, most times it's not

[@haribocz1]

Very useful information, it helps me a lot to prepare for my surgery exam. Thank you a lot. P.S it will be awesome if ull shoot some video about suture materials and how to choose which would clouser to use. Hello from Czech Republic ;)

[@citizensurgeon]

Kiril, thanks for the feedback, that’s a great idea. I’ll put up a video about sutures and needles, that will be fun!

[@haribocz1]

@@citizensurgeon And one more idea for the next video. It will be great to lear something about necrotizing soft tissue infections classification,types, and managment. Thx again 😁

[@citizensurgeon]

@@haribocz1 great idea, I can do that, easy :)

[@chrissyhughes4267]

Just had a pannilectomy in January.I don’t know how or what happened, it’s draining … not open , but looks it

[@deshnidhisingh4928]

Thank you so much sir for such a wonderful information 🙏

[@citizensurgeon]

Excited that you enjoyed it!

[@muslimrevertt]

I’ve just had incision infection five years after gallbladder removal is this normal

[@anakhan6515]

Thank you Dr

[@ahburn9975]

would appreciate it if you'd mention one of the appropriate abx to be given to a patient before surgery, for my case study :(

[@citizensurgeon]

Check out this from the University of Michigan as a reference: www.med.umich.edu/asp/pdf/surgical_prophylaxis/surg-ppx_Guideline.pdf

[@ahburn9975]

@@citizensurgeon wow! Thank you for the quick response doc! 🤍 Appreciate it!! Thank you for helping us learn amidst pandemic 🤍

[@yousefnaser4349]

thank you

[@citizensurgeon]

You are welcome! What next?

[@Africanremote]

Kindly I have sutured wound but it cracked open and have some dicharge

[@citizensurgeon]

Certainly see a healthcare professional is you're worried. Often when a wound opens it will heal by secondary intention as long as there are no impediments to healing such as infection, inflammation, foreign body or others.

[@kumbakumba794]

I'm having the infection in my wound after operation since November 23 .

[@citizensurgeon]

I would definitely call your surgeon! Good luck!

[@ahmedabdnaser422]

Thanks alot for heavy informations I have a question What is the incidance of SSI?

[@citizensurgeon]

Definitely depends on Comorbidities and type of wound class but across the board I’d say 3-5% is a safe answer

[@zilvinasalbrikas1519]

What is the roles/duties for Surgical site surveillance coordinator?

[@citizensurgeon]

Hi there, thank you for the comment and I apologize for the delayed reply I had to give this some thought. Many hospitals are a part of a surgical site infection surveillance network in order to protocolize and implement guidelines for preventing, identifying and caring for SSIs. As a part of those programs a hospital will employ a SSIS coordinator. There is a paper in JHI by Abbas et al in 2019 that demonstrated an overall reduction of SSI by 35% in participating networks by the 9th year. The roles/duties would be similar to a coordinator for the NSQIP program and include education, maintenance of the database, data input, etc. Great question and I learned something by researching the answer so thank you!

[@noraclark7677]

I am clueless about these things but your mention of an abscess in muscle piqued my curiosity. Why would an abscess develop in a muscle without an obvious reason like a surgical incision or an open wound?

[@citizensurgeon]

Nora you’re exactly right, we typically would not see a spontaneous muscle abscess but it can happen after blunt trauma or if someone is immunosuppressed or bacteremic. For surgical site infections the superficial, deep or organ space are always following a procedure.

[@noraclark7677]

@@citizensurgeon Thank you! I was curious because I did in fact have an abscess in the muscle in my lower leg when I was ten years old! At the time they had no explanation for it but this was back in the sixties. I was a perfectly healthy child with no pre existing conditions. They suggested maybe it was from an injury from the dancing I did but I had not had any issues that way! It has always remained a mystery. But it was a horrible thing!

[@mysticalrose3764]

Hi doctor, i recently had pilonidal sinus operation with open wound surgery now i have pus like yellow colour discharge coming out of it, could you please help lets me know if this is normal

[@citizensurgeon]

Would definitely call your doc! Every surgery and patient is unique and your surgeon would want to know and provide guidance

[@bestever3655]

Loved it thanks doc!

[@citizensurgeon]

Thanks so much for the feedback! Glad you liked it, have a series coming out on fever soon!

[@bestever3655]

@@citizensurgeon really appreciate your efforts 👌

[@masterpiece4660]

My 8 year old daughter just got her appendix removed via licro through her belly button. She has a hard time going to the bathroom, and had a mild fever for 6 days we seen her surgeon he said it was normal today is day 7 and her fever went up to 101.2 is this serious? Should I call her surgeon again tomorrow?

[@gailraynowska7806]

I had a appendectomy and ended up with an abscess at the trochanter insertion site. Why?

[@citizensurgeon]

While I can’t give medical advice and do not know about you and your risk profile I’ll give you a link here for a paper to understand a bit more about surgical site infection in the context of appendicitis. Hope you get better soon. wjes.biomedcentral.com/articles/10.1186/s13017-018-0186-1#:~:text=August%208%2C%202012-,Background,%2C%20and%20costs%20%5B3%5D.w

[@shreyashipatra4166]

Sir i have a lower abdormal surgery 4 month ago after 1.30 months my wound was healed but 2 months ago I saw yellowish type discharge like coconut oil type.... Is coming from my wound area and a I also saw little bit hole after that I consulted to a doctor.. He recommend me dressing alternative day but my wound is not healing when a hole healed beside that hole another hole created I'm very tensed sir plz rply what to do plzzzz sir

[@citizensurgeon]

I'm sorry for the delay, somehow I missed you and am seeing this now. I hope you were able to find some effective treatment for your wound!

[@ussahfrancis6378]

I was operated 7months ago, and recently I started to feel severe pains when am walking and at night. I went back to the Dr that operated me of ovarian cyst and he was unable to detect something even after scanning,then he requested for pelvic examination in which he didn't diagnosed anything,then he requested for laparotomy and I said no to it. pls advice me

[@citizensurgeon]

Im sorry you’re experiencing pain, unfortunately I can’t give medical advice but I always recommend seeking out a second opinion from another physician. Good luck and I hope you recover soon.

[@faithchoonya5134]

Thanks Dr really loved it and it was helpful at the same time 👍♥️

[@citizensurgeon]

So glad you enjoyed it! Let me know what topic you are most interested in learning about!

[@faithchoonya5134]

@@citizensurgeon Dr the hernias really confuse me would love if you can do a video on them thank you

[@ayask137]

Why no hair removal. Can you explain this please

[@citizensurgeon]

We can clip hair without an increase in surgical site infection but if we shave the area with a blade there is epithelial damage and an increased risk of SSI, I usually don’t even clip hair unless it’s a very hairy area

[@langhejoel9272]

Thanks alot doc🔥🔥

[@citizensurgeon]

Absolutely thanks for engaging! What else do you want to learn?

[@usamommy4446]

I just got 4 hernias fixed yesterday and that evening I started having bad bad liquid building up. It's so sore everywhere on my lower belly and bruising. Called doctor and they want me to come in next week. Not even hydrocodone will help keep the pain away. There is also red dots that are going out the cut by the old c sec line that was the worst hernia.

[@citizensurgeon]

I’m sorry you’re suffering and with pain, unfortunately I can’t give medical advice on a forum like this but I’d say this deserves another call to your doctor if you’re worried and not satisfied with the plan.

[@usamommy4446]

@@citizensurgeon Thank you sir and I know that you cannot give advice. I am going in tomorrow because I just started bleeding like water from the sites. It's stopped after about a minute

[@citizensurgeon]

I hope everything turns out well for you!

[@usamommy4446]

@@citizensurgeon I should hire you to fix the hiatal hernia that they couldn't repair.. ;) Have a good night and thank you for the well wishes. And love the content you provide ☺️

[@shreyashipatra4166]

Plz sir give me some suggestion

[@sumitabandopadhyay39]

I am from india , my three incision pus out for one month , doctor changes antibiotic but no recovery , what can I do now ?

[@citizensurgeon]

I’m sorry this happened I would definitely return to your surgeon, many times this indicates a wound needs to be drained. Good luck!

[@prasannak8541]

How r u?? I'm in same situation

[@prasannak8541]

Plzzzz em use chesaro cheppandi

[@JariatuKargbo-dx6wh]

I woke just now and I have some swollen around my pins and tenderness and am having fever too

[@citizensurgeon]

Dang! Definitely want to call your surgeon on this!

[@mba2764]

Professional video

[@citizensurgeon]

Thank you! Week by week I think it’s getting better!

[@tasha.ray1112]

Hello doctor. My son had testicle torsion surgery.. luckily both testicles were saved.. but on the scrotum I see some pus formed.. I took him back to hospital, they did not drain it.. they just gave cotrimoxazole again after 2 weeks that he took it.. and asked me to disinfect it using Betadine solution and apply fusidic acid cream.. there’s still a little yellow thing inside after 4 days on antibiotics intake and I would like to know if I have to take him back so they drain it?? Or is it going to heal by itself? I’m worried. He said it’s not painful.. I don’t understand how there’s pus when I took all precautions needed.. cleaned the area with precaution etc.. surgery was done on the 10th of December and he got discharged on 12th December then I started the cotrimoxazole antibiotic until 17.. he got the same antibiotic on 1st of January. What should I do please? Is it dangerous? Thank you for replying 🙏

[@citizensurgeon]

I’m sorry you had this experience with your son, both the torsion and the post operative infection. First , certainly follow up with your doctor if you’re worried about the wound, the physician will be able to provide either reassurance or another course of action. Second, no matter how well we optimize with preoperative antibiotics, chlorhexadine prep or other modalities the risk of SSI is never zero. Good luck and I wish him a full recovery!

[@tasha.ray1112]

@@citizensurgeon thank you so much Doctor. I took him to the hospital again and the Doctor said the wound is healing..He is doing much better now🙏

[@ahmadabughazla3333]

Where is the link please

[@citizensurgeon]

Hi Ahmad, what link are you referring to?

[@vipinsingh8113]

Hey Doctor, I have gone through the surgery of epidermal cyst at perianal area, at 10th days steches were removed but on same day both the edges of wound get separated and now wound is completely open about 1.4 cm diameter, there is itching at boundary. My surgeon told me take antibiotics and continue the dressing wound will heal by itself. Pls suggest me what to do now, can we renew the wound edges and restore it with absorbing suture material ,or let it be heal by itself Pls suggest Tomorrow I am going to show the wound to surgeon

[@citizensurgeon]

Unfortunately I can’t give medical advice but I can say that when a wound opens we will let it heal by secondary intention on its own :) if there is cellulitis and infection antibiotics can help.

[@vipinsingh8113]

@@citizensurgeon Thank you doc

[@Saumil5]

@@vipinsingh8113 hey Vipin, I underwent periananl abscess drainage and fistula surgery via Laser... 12th day my stitches got removed , just like you , i could see the open wound with sides of skin far apart... I started seeing some white viscous liquid while cleaning the wound , i am daily doing dressing with Betadine , if possible could you please share your email address or contact ? What more should be done ? My surgeon is not very Cooperative or expressive , he simply says it will be fine once skin is there, just continue dressing,

[@otuokwulillian9092]

❤❤❤

[@citizensurgeon]

Thank you!!

[@ShelemaAmente-hr6bb]

💛💛💛💛💛💛

[@abdiambobedaso6734]

👍♥️

[@citizensurgeon]

Glad you enjoyed it!

[@yuiyui3331]

Keep doing. We like to learn from the real guy. 🫡💗

[@citizensurgeon]

Love that!