MBBS OSCE · General Surgery
OSCE — Surgical Site Infection
Eight-minute OSCE station on Surgical Site Infection: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Surgical Site Infection.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
SSI = infection at the surgical site within 30 days (or 90 days if implant placed), classified by CDC into superficial incisional (skin/subcut), deep incisional (fascia/muscle) and organ/space. Affects 2 to 5% of procedures, doubles mortality, and adds 7 to 10 days to length of stay. Most common organism in clean surgery: Staphylococcus aureus. Prevention bundle: prophylactic antibiotics within 60 min of incision (re-dose at 4 h or after 1500 mL blood loss), normothermia, glycaemic control, clipping (not shaving), supplemental oxygen, chlorhexidine skin prep, WHO Surgical Safety Checklist.
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Purulent drainage from a surgical wound within 30 days (90 days if implant) = SS |
| Safety | Wound dehiscence with viscera visible = deep/organ-space SSI or fascial dehiscen |
| Safety | Pain out of proportion to wound appearance, systemic toxicity, crepitus or dusky |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.