| Risk Factor |
Important |
Feasible |
Feasible, Difficult
(e.g. Chart Review) |
| Age |
6 |
6 |
0 |
| Gender |
3 |
5 |
0 |
| Body Mass Index |
6 |
4 |
1 |
| Comorbidity Score (Charlson or whatever is available) |
5 |
2 |
1 |
| Diabetes |
6 |
3 |
1 |
| Chronic Lung Disease |
3 |
2 |
1 |
| Chronic Kidney Disease |
3 |
2 |
1 |
| Peripheral vascular disease |
2 |
1 |
1 |
| Prior site irradiation (At any time) |
3 |
1 |
2 |
| Recent operation (Within 30 days) |
5 |
4 |
0 |
| Skin carriage of staphylococci |
3 |
1 |
1 |
| Skin disease in the area of surgery (eg, psoriasis) |
2 |
0 |
1 |
| Wound Class |
6 |
5 |
1 |
| Emergent Procedure |
5 |
5 |
0 |
| ASA Score |
5 |
5 |
0 |
| Revision/Re-do Operation |
4 |
4 |
0 |
| Pre-Op Hospitalization (# of days) |
5 |
5 |
0 |
| Hx of MRSA |
3 |
2 |
1 |
| Homelessness |
1 |
0 |
0 |
| Hospitalizations in Prior 12 Months (#) |
0 |
0 |
0 |
| Surgical Site |
3 |
5 |
0 |
| Insurance/Payor Source |
0 |
1 |
0 |
| Hx Rheumatologic Disease |
1 |
2 |
0 |
| Previous Surgical Site Infection |
5 |
4 |
1 |
| Instututionalized |
2 |
2 |
0 |
| NNIS Risk Index |
4 |
1 |
1 |
| Glucose Control (Hgb A1C and Pre-op Glucose) |
6 |
5 |
0 |
| Hypocholesterolemia |
0 |
1 |
0 |
| Preoperative anemia |
6 |
6 |
0 |
| Postoperative anemia |
3 |
4 |
0 |
| Remote infection |
4 |
3 |
1 |
| Malnutrition (Wt loss, albumin, prealbumin) |
6 |
4 |
1 |
| Smoking |
6 |
6 |
0 |
| Alcohol Abuse |
4 |
5 |
0 |
| Substance Abuse |
1 |
2 |
0 |
| Staph Aureus Colonization |
3 |
2 |
0 |
| Preoperative Shower |
4 |
3 |
0 |
| Immunosuppressive Drugs Pre-Op |
5 |
5 |
0 |
| Pre-Op Albumin Level |
6 |
5 |
0 |
| Ascites |
5 |
2 |
1 |
| Chronic inflammation |
2 |
1 |
1 |
| Corticosteroid therapy w/in 30 Days |
4 |
3 |
0 |
| Duration of Surgery (min) |
6 |
5 |
0 |
| Tourniquet Time |
2 |
2 |
0 |
| Post-Op Mechanical Ventilation |
2 |
2 |
0 |
| Surgeon Experience (# Past 12 Months) |
3 |
2 |
0 |
| Surgeon Age |
0 |
0 |
0 |
| Laparoscopic Approach |
5 |
5 |
0 |
| General Anesthesia |
1 |
2 |
0 |
| No. of Personnel in OR |
3 |
2 |
0 |
| Trainee (Lowest Level) Scrubbed in OR |
2 |
2 |
0 |
| OR Traffic |
1 |
1 |
0 |
| Timely Pre-Op Abx |
6 |
6 |
0 |
| Appropriate Pre-op Abx |
6 |
6 |
0 |
| Discontinuation of Post-Op Abx <24 hr |
4 |
4 |
0 |
| Appropriate Intra-Op Re-dosing of Abx |
5 |
5 |
0 |
| Lowest Intra-Op Temperature |
5 |
5 |
0 |
| Temperature on Arrival to PACU |
5 |
5 |
0 |
| Peri-Op Glucose <100 |
0 |
0 |
0 |
| Peri-Op Glucose <200 |
6 |
4 |
1 |
| Peri-Op Transfusion |
5 |
4 |
1 |
| Skin Prep |
5 |
5 |
0 |
| Hair Removal |
5 |
5 |
0 |
| Abx Irrigation |
1 |
2 |
0 |
| Injections into Wound (e.g., Local Anesthetic) |
0 |
1 |
0 |
| Implant |
3 |
3 |
0 |
| Anesthetic Drugs |
0 |
0 |
0 |
| Outpatient Surgery |
2 |
2 |
0 |
| Inpatient Surgery |
2 |
2 |
0 |
| Post-Op Admit |
1 |
1 |
0 |
| Laminar Airflow OR |
1 |
1 |
0 |
| HEPA Filtered OR |
1 |
1 |
0 |
| Number of Procedures (in same OR session) |
1 |
1 |
0 |
| Use of Drain |
6 |
5 |
0 |
| ICU Admission Post-Op |
1 |
1 |
0 |
| Perioperative Hyperoxia (FiO2 80%) |
3 |
3 |
0 |
| Peri-Op Insulin Administration |
2 |
2 |
0 |
| Peri-Op Proton Pump Inhibitor |
1 |
1 |
0 |
| Peri-Op VTE Prophylaxis |
2 |
2 |
0 |
| Post-Op Wound Care by Nurse |
2 |
2 |
0 |
| Anticoagulation Medication |
2 |
2 |
0 |
| Post-Op Ambulation (What Day?) |
1 |
1 |
0 |
| Liters of IV Fluid in OR |
4 |
4 |
0 |
| Liters of Fluid 24 hrs Post-Op |
2 |
2 |
0 |
| Central Line |
2 |
3 |
0 |
| Pre-Op Hemoglobobin |
5 |
5 |
0 |
| Use of Stryker Suit |
0 |
1 |
0 |
| Surgeon Beard |
0 |
1 |
0 |
| Tissue expander use |
0 |
0 |
0 |
| Daily living assistance needed |
2 |
1 |
0 |
| Excessive blood loss; > 1 liter |
4 |
3 |
0 |
| Suture material (Deep, and in wound) |
4 |
3 |
0 |
| Incision method |
1 |
1 |
0 |
| Frequency of glove change |
1 |
0 |
0 |
| Subcutaneous hematoma |
4 |
2 |
0 |
| Hx of cancer |
2 |
2 |
0 |
| Periop allogeneic blood transfusion |
3 |
3 |
0 |
| Interop vasopressor |
3 |
3 |
0 |
| preop mechanical ventilation |
1 |
1 |
0 |
| Hx of abx allergy |
1 |
2 |
0 |
| Preop urinary catheterization |
2 |
3 |
0 |
| Skin closure method |
3 |
3 |
0 |
| Periop lapse in discipline? |
3 |
1 |
1 |
| Transfer from another hospital |
0 |
1 |
0 |
| Tumor necrosis factor blockers |
0 |
1 |
0 |
| Development of DVT |
0 |
1 |
0 |
| Intraop inspired O2 < 50% |
1 |
2 |
0 |
| Duration of hypothermia; < 35.5 |
4 |
1 |
1 |
| Tracheotomy |
0 |
1 |
0 |
| Bowel or bladder dysfunction |
0 |
0 |
1 |
| No. of surgeons scrubbed |
1 |
2 |
0 |
| Hx of COPD |
1 |
2 |
0 |
540 Gaither Road Rockville, MD 20850 