Surgical site infections (SSIs) are healthcare-associated infections that impact 0.5% to 3% of those undergoing surgery and typically result in longer hospital stays than patients without infection. Research suggests a correlation between preoperative nasal microbiota composition and postoperative infection rates and subsequent infections.
Early diagnosis of infections post nasal surgery can prevent serious complications, including tissue damage and permanent deformities. Signs of infection include redness, swelling and foul odor.
Risk factors
A surgical site infection (SSI) is a serious complication associated with any procedure that involves cutting through skin, such as cosmetic procedures or orthopedic surgeries. An infection at this location may lead to prolonged hospital stays, increased costs, higher reoperation rates or even death; they’re one of the primary sources of healthcare-associated infections; however, with appropriate clinical practice, patient preparation, and surgical technique (PPCPT), it should be preventable.
Any surgery that creates a break in the skin increases risk for infection because this dismantles your body’s natural barriers to infection. There are various things you can do to minimize this risk in surgical wounds, including proper cleaning prior and after surgery, dressing appropriately and following all instructions from doctors regarding care instructions.
SSIs (surgical site infections) can occur anywhere on or under a surgical wound and range from superficial incisional infections to deeper organ or space infections. Pathogens from operating room environments, surgeon hands or instruments or patient own skin may enter through infected wounds into surgical sites; occasionally bacteria from patients’ bowel flora or stomach bacteria of elderly patients with hypo- or achlorhydria can enter too.
SSI risk depends on both the depth of infection and type of cardiac procedure performed. Coronary artery bypass graft, mechanical circulatory support or reoperation for pericardial effusion or tamponade surgeries increase chances for skin and tissue infection around an incision more likely.
Surgical site infections typically appear within 5 to 7 days following surgery; however, symptoms can appear up to 3 weeks later in patients who had prostheses placed. Risk factors that increase surgical site infections for male patients include immunosuppression and diabetes.
Maintaining an infection-free surgical site after nasal surgery is the primary objective for any medical provider. Proper washing, skin preparation using alcohol-based antiseptics in the operating room and wearing surgical gloves with antimicrobial prophylaxis all can reduce the risk of surgical site infections (SSI). Furthermore, taking antibiotics prior to surgery for potential bacterial infections is also essential.
Symptoms
Surgical site infections (SSIs) occur when harmful organisms enter the body through wounds caused by surgery, either due to bacteria in the operating room, contaminated surgical tools or preexisting skin blemishes that migrate onto surgical sites during a procedure. They affect approximately 1-3% of those undergoing surgery procedures.
An SSI can be serious, requiring antibiotic treatment or hospitalization – or, left untreated, sepsis (an infection in the blood) and even death.
Your skin provides a natural defense against infection, but surgery that creates cuts in it can introduce germs into your system and cause infection. The type of infection depends on where and what kind of tissue an incision was made in; one type is deep incisional SSI that occurs underneath an incision area and requires antibiotic treatment to eradicate.
An infection of the layers of skin called superficial Staphylococcal Infection, or SSI, often arises around your stitches. Antibiotics may be necessary to treat it effectively.
An infection at the surgical site could also be caused by reacting negatively to medications, nasal packing or sutures used during and post procedure, which may hinder healing processes and lead to symptoms like swelling, pain and drainage from the area around it.
Local reactions may arise during surgery itself, such as bleeding. Should this occur, it’s essential that you follow your surgeon’s instructions for care and treatment immediately.
Infection at the surgical site after nasal septoplasty is rare but may occur. You can help avoid infection with appropriate wound care and the appropriate use of antibiotics as directed. You should contact your surgeon if any signs of infection arise, such as fever, pus, redness around wound, fever or pus formation or reddening at wound site, changes in breathing pattern or discomfort near surgical site area.
Treatment
The sinuses are four cavities or rooms located on either side of the nose that produce around one quart of mucus every day. Sometimes these sinuses become blocked, leading to sinus infections, stuffy nose, headaches or nosebleeds; when medical treatments do not help, nasal surgery may be recommended as a possible solution.
An external or internal incision will be made by your surgeon in order to modify bone and cartilage structures of your nose. Depending on its extent, tissue from other parts of your body such as ears or ribs may need to be moved around in order to alter its shape and give way for its transformation into the nose. Stitching or suturing of incisions may also be needed before being secured with a splint until its healing process takes place over two to seven days.
As part of a nasal septoplasty procedure to correct a crooked nose, doctors will alter the bone and cartilage that separates your nostrils in order to improve breathing and sleep quality. Doctors use either local or general anesthesia during this surgery procedure.
Sinus infections are a risk after nasal surgery, but they’re treatable. Your doctor will likely prescribe antibiotics and other medication to clear out your sinuses and restore normal drainage. Be sure to follow their advice, such as refraining from activities which promote bleeding and keeping wounds clean.
If you suffer from chronic sinus infections, balloon sinuplasty could be just what is needed to unclog them. This minimally invasive surgery takes place through your nostrils without leaving any scarring behind and won’t alter the shape or exterior appearance of your nose either. A thin wire is passed into the sinus opening while a catheter with an inflatable balloon attached is guided in place and once in position the balloon can be inflated and open the sinus and allow normal drainage.
After sinus surgery, you should anticipate some swelling and bruising, along with any nosebleeds which may occur within the first few days after surgery, though they should subside on their own over time. Irrigate your sinuses with a saline spray to keep crusts from forming as the area heals; take any prescribed pain relief medication (or extra-strength acetaminophen such as Tylenol if needed).
Prevention
Surgical site infections (SSIs) are an enormous source of morbidity and costs, leading to longer hospital stays, higher rates of reoperations and even increased mortality rates. Prevention of these infections is the best way to minimize morbidity; this can be accomplished via appropriate antibiotic prophylaxis as well as patient and surgical site preparation.
At the outset of nasal surgery, the surgeon makes an incision above one of the second molars inside the mouth and enters the sinus through this opening. They may use either an absorbable or non-absorbable stent depending on what kind of surgery was conducted – it all depends on your requirements and whether packing will be needed afterwards to control bleeding or avoid infections.
Nasal surgery can treat many conditions, such as nasal polyps, inferior turbinate hypertrophy, and chronic rhinosinusitis. Unfortunately, post-surgery complications may include inflammation of sinuses and scarring (synechia). Therefore, prior to performing any nasal surgery procedure it is crucial to perform a comprehensive preoperative evaluation and discuss all medications that could increase bleeding risk or have anticoagulant properties with your surgeon.
Surgeons must ensure that nasal passages are clear to allow proper ventilation, and check sinuses for signs of infection such as pain, drainage or any change in sense of smell.
Avoiding infection at the surgical site after nasal surgery by following your surgeon’s instructions for care, including keeping it clean and taking all prescribed medication. Any signs or symptoms of infection, such as pain or drainage, must be reported immediately to your healthcare provider.
Preventing surgical site infection (SSI) has been recommended through several measures, such as taking preoperative showers with alcohol-based hand rub and decolonization with Staphylococcus aureus with antibiotics such as mupirocin or other agents; using sterile gloves during surgical skin preparation in the operating room without performing unnecessary removal of hair; using first or second generation cephalosporin antibiotic prophylaxis taken within 120 minutes from incision (considering half life of antibiotic) while providing patient education on these guidelines.
