Surgical Site Infections and Incontinence Care

With the passing of Congresswoman Eddie Bernice Johnson on New Year’s Eve and the report of what caused her death, I felt it necessary to highlight a topic that is uncomfortable but substantial… the consequences of incontinence. Let’s start with some anatomy. What is the largest organ of the body… It’s the skin. It covers the entire external of you. Your skin, despite location, is our natural barrier against infection. Any break in the skin, like surgery, can lead to an infection. For any surgical site that is located geographically near the backside and genitalia areas, incontinence care must be a fundamental priority.

By definition, incontinence(urine or feces) is the involuntary leakage from the bladder or rectum. Incontinence can affect both men and women in any age group but is most common in older individuals.

As the population ages, the number of elderly suffering from bowel and bladder control problems is increasing. The costs of this problem are personal, physical, and financial, and many with incontinence suffer social isolation, ill health, and even feel like a burden to others because they cannot manage or control body functions. Loved ones with risk factors of advanced age, malnutrition, mobility limitations, obesity, steroid use, diabetes, some cancers, immunosuppressive concerns, and smoking have a higher incidence of surgical site infections.

Incontinence is, unfortunately, a reality in eldercare and after many surgical procedures. When your loved one has a lower body surgery, urine or feces in a surgical wound is possible. It can and will cause an infection. The visualization of wounds must be a primary concern. A healthcare professional must ensure surgical wounds are tracked, and bowel and bladder care is addressed frequently.

What are the signs of surgical wound infection:

· Fever(sometimes low-grade) a common symptom

· a foul smell, or drainage from the wound

· redness around the wound

· pain, different from incisional pain

· the presence of pus

As Your Proactive Caregiver Advocate, surgical site infections need not occur. They are largely preventable when preventive measures and “care” are given with the utmost excellence. Every healthcare organization has policies and procedures in place to reduce or eliminate surgical site infections. When evidence-based care is not followed, bad things can happen. Side-bar…if your loved one is in a facility, please stay watchful, day and night…night and day! Be Safe! Be Well!

Dr. Cynthia J. Hickman is a retired registered nurse and case manager, CEO of Your Proactive Caregiver Advocate and author of From the Lens of Daughter, Nurse, and Caregiver: A Journey of Duty and Honor, and The Black Book of Important Information for Caregivers.

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