Clinically Speaking: Questions and Answers on Avoiding Infections When Undergoing Outpatient Surgery

Having to undergo any type of surgery, no matter how simple the procedure may seem, can be scary. The Covid-19 pandemic, with its new health risks and protocols to follow, makes it even more stressful for patients.

While the pandemic initially decreased the number of outpatient surgeries being performed, they returned to pre-pandemic levels, which had been on the rise even before that: In 1995, 13.4 million surgeries were performed in hospital facilities and for 2018, there were 19.2 million.

It is common to get an infection after undergoing a procedure in a surgical center or hospital. That’s one of the reasons why it’s important for patients to learn as much as possible to stay safe before undergoing a procedure. With that in mind, Healthy Women reached out to Dr. Dele Ogunseitan, professor of public health and disease prevention and population health at the University of California, to ask what questions people should be asking their health care providers (HCPs). for its acronym in English) before undergoing outpatient surgery.

“To a certain extent, every medical procedure has a personal dimension because we are all

individuals with unique characteristics,” Ogunseitan said in an email. “However, there are some fundamental practices that support the expertise of professionals, so that the quality of care can be controlled. Therefore, the most important thing is to pay close attention to the recommendations of health care providers as to how best to prepare for outpatient surgery.”

What should I do to prepare before undergoing outpatient surgery?

While every surgery is different, there are specific steps you can take to reduce your risk of getting an infection, according to the Association for Professionals in Infection Control and Epidemiology. These include:

  • Contact your health care team. Be open and honest about your health and medical history, including allergies. Make sure you have a clear understanding of the procedure you are about to have, and don’t be afraid to ask for more information if you need it.
  • Learn about medications. Ask your HCP if you’ll need to take an antibiotic after your procedure, and if so, find out why and if you really need it. This is because overuse of antibiotics can lead to an infection that is difficult to treat.
  • Practice good hygiene. Best hygiene practices include careful bathing with prescribed antiseptic soap and hand washing, both of which are very important to reduce the chance of infection before and after the surgical procedure. Surgeons also sometimes prescribe a nasal spray to kill bacteria before surgery. Also, do not shave the area where the incision will be made, and avoid wearing deodorant or lotion on the day of surgery.
  • Eat well: Focus on fruits and vegetables in the days leading up to surgery. Avoid processed foods and alcohol.
  • Get a good night’s sleep before surgery: A poor night’s sleep before surgery is associated with more pain after the procedure.

Am I in danger of developing an infection while in the hospital or surgery center?

Surgical site infections (SSIs), infections that develop at incision sites, are the most common infections people develop after surgery. However, the risk is relatively low: According to a 2014 study, only 3% of patients developed an SSI within 14 days, and nearly 5% developed one within 30 days after outpatient surgery.

There are also other infections to be aware of, such as healthcare-associated infections, which are infections that patients contract in a healthcare setting that may or may not be resistant to antibiotics.

Hospitals are aware of the risks of antibiotic-resistant healthcare-associated infections, Ogunseitan said. Healthcare providers should also follow CDC best practices for handwashing, among other hygiene guidelines, which should reduce your chance of getting sick after surgery.

You are less likely to get an infection during outpatient surgery than with inpatient surgery, but the longer you stay in a health care facility, the greater your risk of getting an infection.

What can I do to reduce the risk of developing an infection?

Be proactive. Don’t be afraid to ask anyone who comes into your room, whether in a health care facility or while you’re recovering at home, to wash their hands. Also, keep in mind the CDC’s best practices for patient safety:

  • Remind all visitors, including HCPs, to wash their hands when they enter your room.
  • If HCPs don’t wear protective gear like gowns and gloves when they’re supposed to, ask them to put it on to help prevent the spread of germs and infection.
  • Let the hospital staff clean your room.
  • Understand that health professionals may ask you to be tested for an antibiotic-resistant germ, despite the lack of symptoms.
  • Talk to your HCPs about any procedures or treatments you have received that did not take place in the US.
  • Be sure to follow any instructions your HCP gives you before your surgery, which may change depending on the procedure you have.

What are the signs/symptoms of an antimicrobial resistant infection?

An antimicrobial resistant infection (AMR) is one that cannot be easily treated with medication. HCPs are the only ones who can determine if a post-surgery infection is truly an AMR-related infection. So your HCP should follow the CDC guidelines for treating AMR infections.

One of the first signs of any infection is a fever. That may be followed by symptoms including:

  • swollen lymph nodes
  • Swelling or pus around the surgery site
  • Persistent nausea or vomiting
  • Confusion or lack of awareness (also called delirium)
  • Pain

If you have any of these symptoms, contact your HCP right away or go to the hospital.

What should I do if I see something that concerns me once I am home?

Talk to your HCP about any concerns you have before you leave the health care facility. If you come home and you don’t feel well, call them.

Above all, if you feel like you’re getting worse quickly, call 911 or have a loved one take you to the hospital.

“Some infections can progress very quickly and it is better to be cautious than sorry,” Ogunseitan said.

What information do I need from providers regarding post-surgery home care to prevent infection?

Before surgery, ask your HCP:

  • If you will need any special equipment when you get home
  • when can you go back to work
  • When can you start exercising or any other physical activity?
  • If there are other restrictions you must follow

Also, follow all instructions provided by your HCP, including any special instructions on how to care for your surgical incision. Depending on the procedure, these could include:

  • Always wash your hands and maintain good hygiene practices.
  • Do not start physical activity until your HCP says it is okay.
  • Make sure you have a clear understanding of how to care for your wound.
  • Make sure anyone who helps you clean or replace a dressing on your incision follows proper hygiene practices.

Ogunseitan emphasized that it is your responsibility to follow these instructions, but if you are not sure what to do or think you have made a mistake, talk to your HCP for help as soon as possible.

This resource was created with the support of Pfizer Inc.

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