Patient Selection & Risk Stratification

Clinical Objective

Identify patients at elevated risk for surgical site infection prior to scheduling or proceeding with elective procedures. Risk stratification enables targeted prophylactic measures and informed client communication. A structured pre-surgical assessment reduces preventable SSIs by allowing protocol modifications before the patient reaches the operating room.

Protocol Steps

1. 1

   Review complete medical history, including prior infections, immunosuppressive therapy, and concurrent disease.

2. 2

   Assess body condition score (BCS); obesity (BCS ≥ 8/9) is an independent SSI risk factor.

3. 3

   Screen for active skin infections, pyoderma, or wounds near the planned surgical site.

4. 4

   Evaluate immune status: confirm vaccination status and assess for conditions causing immunosuppression (hyperadrenocorticism, diabetes mellitus, FIV/FeLV).

5. 5

   Document ASA physical status classification (I–V) and record in the surgical checklist.

6. 6

   For high-risk patients (ASA III+), discuss risk with client and consider whether elective surgery should be deferred.

7. 7

   Flag elevated-risk patients in the surgical schedule to trigger enhanced perioperative protocols.

Key Pitfalls to Avoid

• Proceeding with elective surgery in patients with active skin infections at or near the surgical site.

• Overlooking recent or current corticosteroid administration, which substantially elevates infection risk.

• Failing to communicate identified risk factors to the entire surgical team prior to the procedure.

• Using a binary 'high/low' risk framework rather than a graded, evidence-based classification system.