Surgical Site Infections

A surgical site infection (SSI) is an infection of an area on the body where surgery or a surgical procedure has been performed. SSIs can be caused by bacteria, fungi or viruses and usually occur at the site of the surgical incision, but can also occur in other organs or body systems. SSIs can be minor or life-threatening and may lead to further surgical procedures or prolonged hospital stays. SSIs are a major source of preventable illness and disability, and they are the most common and costly type of healthcare-associated infection.

The Centers for Disease Control and Prevention (CDC) notes that 1 in 20 patients who undergo an operation in the United States develop an SSI. This equates to roughly 300,000 patients every year. Of those, about 8,000 people die from complications due to SSIs.

Causes

SSIs are caused by germs that enter the body during or after a surgery or another procedure that requires an incision to be made in the skin. The germs may be acquired from the patient's own skin or from the equipment or objects used in the surgical procedure. They can also be acquired during a previous hospital stay, which is known as a “cross-contamination” event. Highly contagious viruses are also a potential source of SSIs.

Symptoms

The signs and symptoms of SSIs depend on the type of infection, its location, and the underlying cause. Common signs and symptoms of SSIs include:

Fever
Redness or swelling at the site of the incision
Drainage of pus or other fluids
Pain or tenderness at the site of the incision

Risk factors

Several factors may increase the risk of developing an SSI, including:

Surgeries that involve large incisions, such as an abdominal or pelvic surgery
Poor hygiene or sanitation measures during the surgery
Obesity or diabetes
Smoking or drinking alcohol
Poor nutrition
Longer duration of surgery
Having a weakened immune system

Diagnosis and Treatment

SSIs are typically diagnosed through a physical exam and lab tests of tissue and/or fluid samples from the infected area. Treatment for SSIs depends on the severity of the infection, but usually includes antibiotics and possibly other therapies such as drainage of the infected area, or removal of infected tissue. Some SSIs may require additional surgery, and in rare cases, they can be life-threatening.

Prevention

To help prevent the occurrence of SSIs, the CDC recommends that patients:

Follow pre-operative instructions provided by their healthcare provider
Maintain good hygiene before and after surgery
Ask their surgeon about the use of antibiotics or antiseptics to prevent infection
Follow the recommended instructions for follow-up care after the surgery