Hassan Mohammad Eisa.
BSc,CLS(NCA ), MSc In Clinical Microbiology
Department Of Microbiology
College of Medicine
King Faisal University,Dammam
Kingdome Of Saudi Arabia
Superfical incisional infection
Surgical site infections
Deep inciaional infections
Organ space infections
Wound contamination: The presence of bacteria
within a wound without any host reaction.
Wound colonization: The presence of bacteria within
the wound which do multiply or initiate a host reaction.
Critical colonization: Multiplication of bacteria causing
a delay in wound healing, usually associated with an
exacerbation of pain not previously reported but still with
no overt host reaction.
Wound infection: The deposition and multiplication of
bacteria in tissue with an associated host reaction.
General factors (age,malnutrition,hypoxia,anaemia,maligant
Local factors (necrotic tissue,foreign bodies,tissue
ischaemia,haematoma formation and poor surgical technique)
(Type, virulence, size,direct contact,self-contamination, antibiotic resistance of
organism and airborne dispersal )
Potential wound pathogens
Gram-positive cocci (GAS,GDSand staph-aurus/MRSA)*
Gram-negative aerobic ( p- pseruginosa).
(Enterobacter sps,E-coli,k-sps and Prot-sps)
Anaerobes( Bacteroides and cl).
Fungi: (Yeast and Aspergillus).
Protozoa and Viruses.
The proper collection of specimen for
culture is possibly the most important step:
It must be from the actural site with a sterile syring or
Optimal times for collection.
Sufficient amount of sp.
Appropriate collection devices.
Obtain culture before antibiotics.
WOUND CULTURE IDENTIFICATION and
When and how to take or collect the specimen?
Types of specimens:
Dry sterile filter paper.
Inculation on different types of culture plates.
Incubation at 37C for 1-2days (Bacteria). and 3-5days ,in case a
mold or yeast .
Gas – Liquid Chromatography (GLC)
Preparation & Fixation of the smear.
Procedure of the stain:
Crystal violet. (primary staining)
Decolorization (destaining) by ethanol.
Counter-staining by Safranin.
Wash with water, blot and dry the slide.
Gram Positive COCCI
Gram Negative Rods
• The prevetion of wound infection should be a primary management
objective for all healthcare practitioners.
sterilisation of instruments.
postive pressure ventilation of operating theatres.
laminar air flow in high risk areas.
exclusion of staff with infections.
proper way of using gloves.
mechanical bowel preparation.
good surgical technique .
Infections of the surgical wound are the most
common hospital acquired infections causing
morbidity and mortality.
Decontamination first is important, using gloves
and aseptic technique in handing and collecting
The initial step is Gram-stain appearance.
Infection rate can be reduced with antibiotic