SSIs are among the most common healthcare-associated infections (HAIs), accounting for up to 21.8% of HAIs according to a study by Magill et al.[4] SSIs not only cause increased morbidity and mortality for patients, but also increase the cost of delivery of care, due to hospital readmissions, increased length of stay,[5,6] and operative revisions, such as removal of hardware in orthopedic surgery infections.[7] Up to 60% of SSIs are preventable and are penalized in the Value-Based Purchasing and Hospital-Acquired Condition Reduction Programs.[8]
The National Healthcare Safety Network (NHSN) divides the types of surgical site infection (SSI) into three categories, based on the depth of the infection. A superficial incisional SSI is an infection that occurs within 30 days of an operative procedure, involves only the skin and subcutaneous tissues of the incision, and has at
least one of the following:
1. “Purulent drainage with or without laboratory confirmation, from the superficial incision.
2. Organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision.
3. At least one of the following signs or symptoms of infection: pain or tenderness, localized swelling, redness, or heat and superficial incision is deliberately opened by surgeon, unless incision is culture negative.
4. Diagnosis of superficial incisional SSI made by a surgeon or attending physician.” [1]
The other two types of infection defined by the NHSN are deep incisional SSI and organ/space SSI.[1] The definition of deep incisional SSI adds a period of up to 90 days after the procedure and includes purulent wound drainage or spontaneous dehiscence or required intentional opening of the wound, constitutional symptoms or positive imaging (e.g. abscess) or diagnosis by other testing or diagnosis by the surgeon or attending physician.[1]
Organ/space SSI includes all of the above signs and/or symptoms for deep incisional infection, but includes infection of any tissue manipulated during surgery.[1] Despite improved practices in infection control, SSIs still cause morbidity, increased length of hospitalization, and mortality.[2] With a goal of containing rising medical care costs, the Centers for Medicare & Medicaid Services selected conditions that are reasonably preventable and are costly to manage. These conditions are not reimbursed by Medicare and include SSI following certain orthopedic procedures as well as other surgical procedures.[3]
After years of decline, rates of cesarean deliveries (CDs) in the US increased to 32% of all births in 2017.[1] As a result, over a million mothers in the US are sent home from the hospital every year nurturing a newborn infant while simultaneously recovering from major surgery. This is of particular concern in the…
This is an exciting week for the EHB – ReliaTect™ Post-Op Dressing with CHG was mentioned in the latest post on one of our favorite blogs – the MedSurgPI News and Blog! If you’re not familiar, MedSurgPI was founded and is led by two highly experienced clinician-executives whose combined backgrounds encompass medicine, surgery, technology, product…
Toni Polk, BSN, RN, CIC, Infection Preventionist at Christus Trinity Mother Frances Hospital in Tyler, Texas, reviews rates of surgical site infections, the importance of preventing surgical site infections, and her experience trialing a novel product in a 45-minute educational webinar available here. In this blog, we’ll provide the highlights of her presentation. Infections Are…
This 3-part series has reviewed the financial impact of SSIs and emerging trends in SSI prevention. It is well accepted that hospital-acquired infection (HAI) after surgery or insertion of a device increases morbidity, mortality, and costs of care for patients and hospitals. Emerging trends in SSI prevention include antimicrobial dressings, with the purpose of protecting…
Welcome to the second blog in this 3-part series about SSIs. In the last blog, the substantial financial impact of SSIs was presented (see Blog #1 of the series). Knowing that the US Centers for Medicare and Medicaid Services (CMS) are no longer reimbursing hospitals for HAIs like SSI1, healthcare professionals are under tremendous pressure…
Welcome to a new 3-part series focusing on SSIs. SSIs are the most common type of hospital-acquired infection (HAI). They occur an estimated 160,000 to 300,000 times per year and account for more than 20% of all HAIs.1 And while the negative clinical outcomes associated with SSIs (ie, morbidity and mortality) are commonly known, there…
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TinyMceFileManager/Academy/ASC_101_resources/Surveillance_NHSN/ASCA_NHSN_SSI_Surveillance_2013.pdf
2. Centers for Disease Control and Prevention. (2017). Procedure-Associated Module SSI. Available at: https://www.cdc.gov/nhsn/pdfs/
pscmanual/9pscssicurrent.pdf
3. Centers for Medicare & Medicaid Services. (2015). Hospital-Acquired Conditions. Available at: https://www.cms.gov/Medicare/Medicare-Fee-forService-Payment/HospitalAcqCond/Hospital-Acquired_Conditions.html
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