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Self-Assessment Questions

General Surgery

Surgical Site Infections: Review Questions

Kamal M.F. Itani, MD, FACS

Dr. Itani is professor of surgery, Boston University, Boston, MA.


Choose the single best answer for each question.

1. All of the following are principles of antibiotic prophylaxis to prevent surgical site infection EXCEPT
  1. Administer intravenous (IV) antibiotics within 1 hour of incision time
  2. Select an antibiotic with a spectrum of activity against pathogens likely to be encountered during surgery
  3. Discontinue antibiotics 48 hours postoperatively
  4. Intraoperatively re-dose cephalosporin prophylactic antibiotics every 2 half-lives for long procedures
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2. All of the following are factors known to be associated with an increased risk for surgical site infection EXCEPT

  1. Hypothermia during surgery
  2. Poorly controlled blood glucose in the perioperative period
  3. Skin shaving
  4. Positive pressure airflow in the operating room
  5. Colonization with Staphylococcus aureus
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3. The use of vancomycin for surgical prophylaxis should be reserved for the following patients EXCEPT

  1. Patients with significant penicillin allergy
  2. Patients with known methicillin-resistant S. aureus (MRSA) colonization
  3. Patients on dialysis
  4. Patients who have had surgical procedures involving implantation of prosthetic materials or devices
  5. Patients in long-term care facilities
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4. All of the following can improve the rate of surgical site infection in the colorectal surgical patient EXCEPT
  1. IV antibiotic administration preoperatively
  2. Oral antibiotic bowel preparation
  3. Prophylactic antibiotics in the postoperative period
  4. Targeting Escherichia coli and Bacteroides fragilis with prophylactic antibiotics
  5. Thorough and complete mechanical bowel preparation
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5. Patients with nasal carriage of S. aureus have an increased risk of surgical site infection by that organism. All of the following statements regarding preoperative treatment of these patients with mupirocin ointment are true EXCEPT

  1. Mupirocin reduces the risk for S. aureus surgical site infection
  2. Mupirocin reduces the risk for S. aureus nosocomial infection overall
  3. Mupirocin cannot prevent infections that originate from colonizing strains transmitted from health care workers
  4. Staphylococcus strains become resistant against mupirocin
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