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SSI Prevention Checklist - Colorectal Protocol
Closing
Intra-Operative
Pre-Incision
Pre-Operative
Use this guide to learn how to help prevent
surgical site infections.
Please click on the section headings to begin.
Content: Illustrations:
Patrick Sullivan, MD Cheryl Castleberry, RN BSSatyen Tripathi, MA CMI
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Pre-Operative Steps
1. Set OR Temperature
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Set OR Temperature
Set operating room temperature to between 72° and 75° F.
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Pre-Incision Steps
4. Double-glove1. Administer Antibiotic
5. Initiate Intra-operative Warming
2. Prep Skin
3. Perfom Universal Prep 6. Prepare General Closing Pan
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Administer Antibiotic
If PCN allergy, give clindamycin (900mg) and aztreonam (2g).
Typical dose is Ancef (2g) and Flagyl (500mg).Administer within one hour of incision.
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Prep Skin
Use Chloraprep® (Betadine® for perineum).Allow for 3 minute drying time.
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Perform Universal Prep
Click here to see sample technique
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Use sterile draping techniques and Ioban occlusive to decrease risk of openings for contamination.
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Universal Prep - Towel Surgical Site
Use sterile towels to frame surgical site.
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Universal Prep - Apply Drape
Drape surgical site. Either universal orlaparotomy with pockets (surgeon’s preference).
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Universal Prep - Use Ioban
Place Ioban covering over surgical site.
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Double-Glove
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All surgical team double-gloves.
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Initiate Intra-Operative Warming
Initiate intra-operative warming of patient.
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Prepare General Closing Pan
Items to include on small Mayo: closing sutures, sterile towels, fresh gloves, closing pan instruments, Bovie, and suction.
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Cover pan with sterile protection until needed.
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Intra-Operative Steps
1. Use Alexis Wound Protecor
2. Perform Irrigation
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Use Alexis Wound Protector
Use Alexis wound protector to prevent contamination and trauma to abdominal wall.
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Perform Irrigation
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Appropriate dose is: 500ml warm NaCl, Gentamycin (240mg) and Clindamycin (600mg)
Perform abdominal wound irrigation with antibiotic solution
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Closing Steps
5. Pass Off New Suction And Bovie
7. Close Skin1. Remove Instruments
6. Close Fascia
8. Apply Sterile Dressing
2. Retrieve Closing Pan
3. Re-Glove
4. Re-Towel Surgical Wound
Click on video to review the closing technique.
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Remove Instruments
Remove hardware and instruments from field; keep drapes. Remove wound protector.
1 of 8
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Retrieve Closing Pan
Bring prepared closing table close to patient.
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Re-Glove
All surgical team re-gloves. Remove outer gloves and replace.
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Gowns are done if preferred by surgeon.
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Re-Towel Surgical Wound
Re-towel the surgical wound with the towels from prepared closing pan.
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Pass Off New Bovie and Suction
Pass off new Bovie and suction from prepared closing pan.
5 of 8
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Close Fascia
Close fascia with new instruments from closing pan.Do not reuse instruments.
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Pre-Operative
Pre-Incision
Intra-Operative
Closing
Skin Closure
Close skin - staples or suture - surgeon preference.
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Skin should be left open for Class III and IV wounds.
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Apply Sterile Dressing
Apply sterile dressing prior to taking off sterile drapes. Peel back Ioban without going outside sterile field.
8 of 8
Primapore or sterile 4x4 with tegaderm (surgeon preference)
Pre-Operative
Pre-Incision
Intra-Operative
Closing
Summary of Steps
1
Pre-Operative StepsSet OR temperature 1
Pre-Incision StepsAdminster antibiotic
2 Prep skin
3 Perform universal prep
4 Double-glove
5 Initiate intra-operative warming
6 Prepare general closing pan
1
Intra-Operative StepsUse Alexis wound protector
2 Perform irrigation
1
Closing StepsRemove instruments
2 Retrieve closing pan
3 Re-glove
4 Re-towel surgical wound
5 Pass off new suction and bovie
6 Close fascia
7 Close skin
8 Apply sterile dressing
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