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Case Study Scenario 3 – Infected Surgical Wound:

Ms Maggie Malone is an obese 52-year-old female, who was admitted to the orthopaedic ward for a total left knee replacement. Staples were the method of wound closure. 

 

Ms Malones’ medical history reveals that she is a heavy smoker, smoking at least 30 cigarettes / day and was diagnosed with Diabetes type 2 around 4 years ago, but has not been following a recommended diet.

 

Day 5 post-op: Maggie is complaining of pain in her left knee, she is febrile 38.7C and an increase in discharge from her wound on her dressings is apparent. On removal of the wound dressings, the wound appeared reddened and inflamed; staples are insitu; an open 1.3cm gap at the lower end of the wound was obvious and is oozing purulent fluid. A wound swab is taken and results show a Methicillin-resistant Staphylococcus aureus (MRSA) infection.

 

On reading the surgeons’ instructions: “Antibiotics to be commenced; Wound cavity to be dressed daily with Dressing as per directed by wound specialist.

 

Ms Malone is reviewed by the wound management nurse who documented the following: 

“Nursing: Wound to heal by secondary intention. Wound cavity measures 13mm long x 10mm wide and 8mm deep, extending to the subcutaneous tissue layer. Wound bed consists of 100% granulation tissue; is malodorous and is oozing a moderate amount of haemopurulent exudate. Staples to remain insitu until day 10 post-op”.

 

Maggie’s Husband comes to visit and he has asked you to explain Maggie’s infection, how 

she got it and how long will she have it for. To be able to explain to Maggie’s husband you need 

to understand the chain of infection.

 

Listed below are the 6 elements required for a disease to be spread (starting with infectious agent). Re-arrange the elements below in the in the correct order.  Beside each element state how it applies to Maggie’s wound.

 (Provide reference).

Infectious agent
Susceptible host
Portal of exit
Reservoir
Mode of transmission
Portal of entry
SCIENCE
HEALTH SCIENCE
NURSING
HLT 54115

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