CIC Surgical Site Infection Prevention 2 — Questions and Answers
Question 1: Which NHSN surgical wound classification carries the highest risk of SSI?
- Dirty-infected (Correct answer)
- Contaminated
- Clean-contaminated
- Clean
Correct answer: Dirty-infected
Dirty-infected wounds involve existing infection or perforated viscera before surgery and carry the highest inherent SSI risk.
Question 2: What is the primary reason for maintaining perioperative normothermia to reduce SSI risk?
- Preserving neutrophil function and tissue oxygen tension (Correct answer)
- Decreasing inhalational anesthetic requirements
- Preventing cardiac arrhythmias during surgery
- Reducing intraoperative blood loss volume
Correct answer: Preserving neutrophil function and tissue oxygen tension
Normothermia (36–38°C) preserves immune cell function and tissue oxygenation, both of which are critical for preventing SSI.
Question 3: Which intraoperative surgical technique factor is a known modifiable SSI risk?
- Dead space creation in wound closure (Correct answer)
- Patient's chronological age
- Inherited immune deficiency disorders
- Patient ABO blood type
Correct answer: Dead space creation in wound closure
Dead space in wound closure allows fluid accumulation and bacterial growth, creating conditions that promote SSI development.
Question 4: What does the NHSN definition require for a deep incisional SSI?
- Infection within 30 days involving fascia and muscle layers (Correct answer)
- Infection within 90 days involving only skin
- Infection at an implant site more than one year after surgery
- Infection identified only after patient discharge
Correct answer: Infection within 30 days involving fascia and muscle layers
NHSN defines deep incisional SSI as an infection occurring within 30 days that involves the fascial and muscle layers at the incision site.
Question 5: Which preoperative intervention reduces nasal carriage of Staphylococcus aureus and lowers SSI risk?
- Intranasal mupirocin application (Correct answer)
- Oral vancomycin prophylaxis
- Chlorhexidine mouthwash rinse
- Systemic beta-lactam prophylaxis alone
Correct answer: Intranasal mupirocin application
Intranasal mupirocin decolonizes S. aureus nasal carriers and has been shown to significantly reduce S. aureus SSI rates.
Question 6: What is the Surgical Care Improvement Project (SCIP) target for perioperative blood glucose in cardiac surgery patients?
- Less than 200 mg/dL in the 18–24 hours postoperatively (Correct answer)
- Less than 150 mg/dL throughout the hospital stay
- Less than 180 mg/dL at the time of incision only
- Less than 250 mg/dL at any point postoperatively
Correct answer: Less than 200 mg/dL in the 18–24 hours postoperatively
SCIP guidelines specify maintaining blood glucose below 200 mg/dL in the 18–24 hours following cardiac surgery to reduce SSI risk.
CIC Surgical Site Infection Prevention 2
Which NHSN surgical wound classification carries the highest risk of SSI?