HWN Suggests

An overview of surgical site infections: aetiology, incidence and risk factors

Until the middle of the 19th century, when Ignaz Semmelweis and Joseph Lister became the pioneers of infection control by introducing antiseptic surgery, most wounds became infected. In cases of deep or extensive infection this resulted in a mortality rate of 70-80%. Since then a number of significant developments, particularly in the field of microbiology, have made surgery safer. However, the overall incidence of healthcare associated infections (HAIs) remains high and represents a substantial burden of disease. In 1992, the US Centers for Disease Control (CDC) revised its definition of 'wound infection', creating the definition 'surgical site infection' (SSI) to prevent confusion between…

read full article

Featured

 Surgical Site Infection Prevention: A Guideline From the ASCRS

The ASCRS developed 18 recommendations regarding institutional interventions, preoperative interventions, intraoperative interventions, and wound care. The recommendations were based on a final review of 139 studies.

Articles of Interest

At-Risk Patient: Surgical Site Infections

Infection at the surgical site remains the second most common adverse event occurring to hospitalized patients and a major source of morbidity following surgical procedures. Infections are more likely to occur after surgery on parts of the body that harbor lots of germs (or are susceptible to cross contamination). Surgical site infections have been shown to increase mortality, readmission rate, length of stay, and cost for patients who incur them.

Financial Impact of Surgical Site Infections on Hospitals

While the topic of financial impact of SSIs may seem trivial, it is not. These infections can be a source of readmissions and a driver of hospital performance. Hence, hospitals have a mandate to improve patient care and safety, which requires infrastructure that can support interventions focused on decreasing adverse events such as SSIs.

Prevention and Treatment of Surgical Site Infection

SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing.

Reducing Surgical Site Infection: Where Do I Look?

Surgical site infections are classified into three categories based upon the location and depth of infection. These include superficial, deep and organ surgical site infections. The classification system most commonly used is based upon that published by Horan et al in 1992,[2] and this system is the basis for that used by the Centers for Disease Control (CDC), the National Healthcare Safety Network, and the National Surgical Quality Improvement Program (NSQIP).

SSI Toolkit

The Surgical Site Infection (SSI) toolkit encompasses ASPIRE Measures TEMP 01, TEMP 02, TEMP 03 and GLU 01 with a focus on best avoiding surgical site infections, orthopedic and general surgery.

Surgical site infections: epidemiology, microbiology and prevention

Surgical site infections (SSIs) are defined as infections occurring up to 30 days after surgery (or up to one year after surgery in patients receiving implants) and affecting either the incision or deep tissue at the operation site. Despite improvements in prevention, SSIs remain a significant clinical problem as they are associated with substantial mortality and morbidity and impose severe demands on healthcare resources. The incidence of SSIs may be as high as 20%, depending on the surgical procedure, the surveillance criteria used, and the quality of data collection.

What are the biggest causes of surgical site infections and how do you prevent them?

SSIs are a common but potentially unavoidable complication following any surgical procedure in which the skin is breached. Complications can range in severity, from wound discharge to more life-threatening infections which can affect the deeper tissues or other parts of the body associated with the surgery.

Resources

CDC

A surgical site infection (SSI) is a type of healthcare-associated infection (HAI). It is an infection that occurs in the part of the body where a surgery took place.

European Centre for Disease Prevention and Control

Surgical site infections (SSIs) are among the most common healthcare-associated infections (HAIs). SSIs are associated with longer post-operative hospital stays, may necessitate additional surgical procedures, may require intensive care, and result in higher attributable morbidity and mortality SSIs are hence an important target for the surveillance of healthcare-associated infections (HAI).