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]
Expert Recommendations on Improving Surgical Care 3 Questions With… features some of the finest thought leaders in healthcare specialties such as Infection Prevention, Vascular Access, Surgical Care and more. These experts answer questions on the latest insights, evidence and current practices. For our newest 3 Questions With… Eloquest Healthcare is proud to feature Maureen Spencer, RN, M.Ed.,…
Eloquest Healthcare is excited to feature Gwen Borlaug, MPH, CIC, FAPIC! Gwen worked at the Wisconsin Division of Public Health (DPH) as the Director of the Healthcare-Associated Infection Prevention Program and as an infection prevention epidemiologist. She launched a statewide public health initiative to reduce surgical site infections, using a surgical care champion to provide peer-to-peer…
Our newest edition of 3 Questions With… 3 Questions With… features some of the finest thought leaders in healthcare specialties such as Infection Prevention, Vascular Access, Surgical Care and more. These experts answer questions on the latest insights, evidence and current practices. For our newest 3 Questions With… Eloquest Healthcare is proud to feature Gwen…
The access to, use of, and quality of health care can vary based on socioeconomic status, which can be measured by income, education, and/or occupation.1,2 Socioeconomic factors can be associated with various health outcomes, one of them being surgical site infection (SSI) which affects up to 5% of surgical procedures nationwide.3 However, the association between…
Surgical site infection (SSI) is a significant postoperative complication that increases morbidity, mortality, and length of stay for surgical patients[1]. On average, 300,000 to 500,000 people develop SSI annually in the United States[1], with 3% of SSIs being fatal and an overall national cost of $10 billion per year[2]. Reducing the risk of SSI begins…
Eloquest Healthcare is excited to welcome Gwen Borlaug, MPH, CIC, FAPIC to the Eloquest Healthcare Blog! Gwen worked at the Wisconsin Division of Public Health (DPH) as the Director of the Healthcare-Associated Infection Prevention Program and as an infection prevention epidemiologist. She launched a statewide public health initiative to reduce surgical site infections, using a surgical…
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