with Dr. Víctor Turrado, Dr. José M. Balibrea
Surgical site infection (SSI) is the most common healthcare-associated infection, accounting for 31% of all infections among hospitalized patients. Advances have been made in infection control practices (operating room ventilation, sterilization, barriers, surgical technique, antibiotic prophylaxis…) but, despite these, SSI remains an important cause of morbidity, prolonged hospitalization and death. Surveillance with feedback to surgeons has been shown an important component of strategies to reduce SSI risk. With this review we aim to make clear the criterion for SSI. Wounds are divided in four classes:
Clinical Background
Clean: an uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital or uninfected urinary tracts are not entered.
Clean-contaminated: operative wounds in which the respiratory, alimentary, genital or urinary tracts are entered under controlled conditions and without unusual contamination.
Contaminated: open, fresh, accidental wounds. Operations with major breaks in sterile technique or gross spillage from the gastrointestinal tract and incisions in which acute, nonpurulent inflammation is encountered including necrotic tissue.
Dirty or infected: old traumatic wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera.
Technique Description
Surgical Site Infection is divided into three categories:
Superficial incisional SSI.
Deep incisional SSI.
Organ/space SSI
Criterion for Superficial Incisional SSI:
< 30 days from surgery.
AND involves only skin and subcutaneous tissue of the incision.
AND the patient has ONE of the following:
Criterion for Deep Incisional SSI:
Within 30 to 90 day from surgery.
AND involves deep soft tissues of the incision.
AND patient has at least ONE of the following:
Criterion for Organ/Space SSI:
Within 30 to 90 days from surgery.
AND infection involves any part of the body deeper that the fascia/muscle layers, that is opened or manipulated during surgery.
AND patient has at least ONE of the following:
Surveillance of SSI is important as it helps to implement strategies to reduce the risk of SSI and allows appropriate treatment.
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