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]
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Progress of Surgical Dressing Development The development of advanced surgical dressings has allowed healthcare providers to optimize patient outcomes and procedural efficiency. Much recent innovation has focused on reducing rates of surgical site infection (SSI) due to its seriousness and financial impact. Antimicrobial dressings help minimize such complications and encourage optimal healing during post‐operative wound…
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Study Design and Measures of Patient Satisfaction In the study “Antimicrobial Dressing versus Standard Dressing in Obese Women Undergoing Cesarean Delivery: A Randomized Controlled Trial” conducted by Dr. Antonio Saad and colleagues at the University of Texas Medical Branch, ReliaTect antimicrobial dressing was compared to standard wound dressing. It is the first published trial comparing…
Surgical site infection (SSI) occurs in 2-5% of all surgeries which correlates to about 157,5000 SSIs in the U.S. on a yearly basis.1 Not only do SSIs impact patient outcomes and mortality rates, but also satisfaction scores and budgets of medical institutions. In the webinar, Reducing Surgical Site Infections: Surgical Stewardship, Maureen P. Spencer discusses…
Back-to-Basics Approach for Improving Surgical Outcomes 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 Peter Graves, BSN, RN,…
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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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