Infection prevention
Infection prevention involves medical and hygiene measures designed to prevent pathogens from entering the body via the surgical wound.
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Important note
This article is for information purposes only and is not a substitute for a medical diagnosis or advice. If you are unsure, or if you require a personalised treatment plan, it is essential that you consult a qualified specialist.
Every surgical procedure – whether medically necessary or cosmetic – breaches our body’s natural protective barrier: the skin. This inevitably creates a risk that bacteria or other pathogens may enter the wound and cause an infection. To reduce this risk to an absolute minimum, a complex system of medical and hygiene measures is employed: the Infection prevention.
In this guide, we explain which invisible safeguards in the clinic ensure your safety and – more importantly – how you, as a patient, can actively help to prevent wound infections through your own behaviour before and after your operation.
Definition: What is infection prevention?
The Infection prevention encompasses all preventative medical, hygiene and behavioural measures aimed at preventing the onset and spread of infectious diseases.
In a surgical context, the term refers primarily to the prevention of post-operative wound infections (Surgical Site Infections, SSI). This ranges from the sterilisation of instruments and the administration of antibiotics to the patient’s proper aftercare of the wound at home.
The 3 phases of prevention: a holistic approach
- Pre-operative (before the operation): Optimising the patient’s health and preparing the surgical site.
- Intraoperatively (during the operation): Strict adherence to asepsis (sterility) in the operating theatre and a gentle surgical technique.
- Post-operative (after the operation): Professional wound care and monitoring during the healing process.
Medical measures: How the hospital protects you
In certified clinics and surgical centres, hygiene is subject to the strictest legal requirements (e.g. those set by the Robert Koch Institute – RKI). The invisible but essential standard measures include:
- Hand hygiene & protective clothing: The entire surgical team carries out surgical hand disinfection and wears sterile gowns, gloves, caps and face masks.
- Asepsis: All instruments, implants (e.g. used in breast augmentation) and drapes are 100 % sterile.
- Skin disinfection: Before the first incision is made, the patient’s surgical site is disinfected several times over a large area using special solutions in order to reduce the skin’s natural bacterial flora.
- Ventilation and air conditioning (VAC): Modern operating theatres are equipped with specialised ventilation systems that filter the air and create positive pressure to prevent germs from entering from outside.
Perioperative antibiotic prophylaxis (PAP)
- What is that? The patient is given a single, high dose of an antibiotic (usually via an intravenous drip, just before anaesthesia is administered).
- The purpose: The aim is to ensure that the maximum concentration of the active ingredient is present in the blood and tissues at the very moment the skin is cut. Should any bacteria enter the wound despite all hygiene measures, they are killed immediately before they can multiply.
- When is it used? Not for every minor operation, but as standard for procedures involving the insertion of foreign materials (implants), or for major, lengthy operations (such as a body lift).
Your role: How to reduce your risk of infection before surgery
Patients have a far greater influence on infection prevention than is often realised. Their immune system is their most important defence.
Checklist: Infection prevention for patients (before surgery)
- ✓Giving up smoking: Nicotine constricts the blood vessels, severely impairs blood circulation and is the number one risk factor for impaired wound healing and infections. Please stop smoking at least 4 weeks before your operation!
- ✓Personal care: Have a thorough shower the evening before or on the morning of the operation (using a disinfectant wash recommended by your doctor, if necessary).
- ✓Do not shave on the day of the operation: Do not shave the surgical area yourself shortly before the procedure. Tiny micro-injuries provide an ideal entry point for bacteria. If necessary, the staff will remove any hair using clippers immediately before the operation.
- ✓Diet & Diabetes: Well-controlled blood sugar levels (in people with diabetes) and a protein-rich diet strengthen the immune system.
Proper wound care after surgery
Preventative care continues at home. An open or freshly stitched wound is vulnerable.
- ✓Treat wounds and apply dressings never with unwashed hands to.
- ✓Leave any special plasters and dressings on the wound for as long as your doctor has instructed.
- ✓Do not have a shower until the doctor has expressly given you the all-clear (usually after 2–3 days, provided you are wearing waterproof plasters). Bathing and swimming are strictly forbidden for several weeks.
- ✓Keep the wound away from pets (dogs/cats), as they can carry dangerous germs.
Residual risk and financial protection
Despite compliance with all hygiene regulations and the administration of antibiotics, there is no such thing as 100 per cent safety. A post-operative wound infection remains a feared residual risk.
If an infection occurs – particularly when implants are involved – swift action is required. Antibiotic treatment is often not sufficient, and a surgical wound debridement (Wound irrigation in the operating theatre, possibly replacement of the implant) may be carried out.
As health insurance funds generally do not cover, or only partially cover, the costs of treating complications arising from purely cosmetic procedures (in accordance with Section 52(2) of Book V of the Social Code), this can result in a huge financial burden. Taking out a Consequential Costs Insurance can be a reliable way of protecting yourself against the high costs of surgery and hospital treatment associated with such infection-related emergency care.
Frequently Asked Questions (FAQ)
This is decided by the surgeon. For many procedures, a single dose (PAP) administered in the operating theatre is sufficient. However, an antibiotic in tablet form is sometimes prescribed for a few days as a precaution. Please follow the dosage schedule strictly and do not stop taking the medicine before the course is complete.
The classic signs (signs of inflammation) are: increasing redness, the area feeling very hot to the touch, throbbing pain, severe swelling, discharge of pus or cloudy fluid, and a fever (above 38°C). If you experience these symptoms, contact your doctor immediately!
MRSA stands for methicillin-resistant Staphylococcus aureus. It is what is known as a „hospital-acquired infection“, which is resistant to many common antibiotics. Modern hospitals often carry out screening (a nasal swab) before major operations to identify carriers of this bacterium and implement specific hygiene measures.
Yes. A large, accumulating haematoma (bruise) or seroma (fluid-filled wound) is an ideal breeding ground for bacteria. Therefore, cooling the area and wearing compression garments to prevent such accumulations is an indirect part of infection prevention.
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