DOI : https :// doi . org / 10.56496 / PIBP4229

Amanda Curtis , RVN https :// orcid . org / 0000-0001-7872-4269

Essity , Willerby

ENVELOPE amandarvn @ hotmail . com

Amanda has over 12 years ' experience as an RVN , as well as previous clinical experience in emergency and critical care environments in primary care and referrals . She has a passion for wound care , infection prevention and quality improvement . After 2 years teaching at the University of South Wales she moved to Essity Animal Health , where she works in a nonclinical role providing evidence-based wound care training to veterinary professionals .

ABSTRACT Veterinary nurses often assess patients postoperatively , so it is vital to be able to recognise the signs of surgical site infections ( SSIs ).

This article considers the use of a three-tier system , which classifies SSIs on their depth and the tissue ( s ) involved , to accurately report the incident . It also describes the use of an active surveillance system to identify trends and enable protocols to be put in place to reduce the incidence of SSIs .

Keywords surgical site infections , wound complication , postoperative

Postoperative wound complications can present in a variety of forms , with different causes and treatment requirements . Surgical site infections ( SSIs ) are a type of postoperative wound complication with the potential to lead to increased morbidity and mortality rates in surgical patients .

The prevalence of SSIs in veterinary medicine is believed to be under-reported and underestimated , according to a prospective cohort study at a veterinary teaching hospital in 2013 – 2014 [ 1 ] . The study looked at SSI rates in 184 soft tissue surgeries and found higher percentages of SSIs than previously reported .

It is important that veterinary nurses ( VNs ), who conduct most of the postoperative assessments of surgical patients , can recognise the signs of SSIs and are able to differentiate between types of postoperative wound complications .

Classification of SSIs

To identify an SSI , VNs need to be able to differentiate between postoperative wound complications ( Appendix 1 [ 2 – 7 ] , pages 25 and 26 ). SSIs and surgical wound dehiscence ( SWD ) can present with similar signs , making them difficult to differentiate [ 2 ] . Although SWD can occur in deep incisional SSIs , not every SWD is an SSI – and vice versa , as deep incisional SSIs can occur without SWD [ 2 ] . SSIs affect the surgical incision site or deeper tissue around the incision and are categorised using a three-tier classification system [ 2 ] ( Figure 1 , page 21 ).

Superficial incisional SSI

This tier of SSI can occur up to 30 days postoperatively and affects only the upper dermal layers and subcutaneous tissue [ 2 ] . Signs include a purulent discharge , the presence of micro-organisms on a diagnostic swab , pain and tenderness around the incisional area , localised swelling , and erythema or heat [ 2 ] . This tier does not include cellulitis , pin-site infections or stitch abscesses [ 2 ] .

20 Veterinary Nursing Journal