Surveillance Method for Surgical Site Infection

Abstract

Surgical Site Infection (SSI) is the third most commonly reported Nosocomial infection and accounts for 14-16% of all Nosocomial infections among hospital inpatients. The morbidity, mortality and the cost to health services of surgical site infections is huge. In addition, many workers have shown that feedback of appropriate data to surgeons has been an indispensable component of strategies to reduce SSI rates. The elements essential for a successful programmed of prevention of SSIs include intensive surveillance, infection control activities and regular feedback of SSI rates to surgeons. Surveillance with information feedback to surgeons and other medical staff has been shown to be an important element in the overall strategy to reduce the numbers of SSIs. Despite the apparent effectiveness in lowering SSI rates when surgeons receive feedback, however, there has been no consensus on which surveillance methods are best for collecting data on SSIs. A successful SSI surveillance program should include standardized definitions of infection, effective surveillance methods and stratification of the SSI rates according to risk factors associated with the development of SSI. For many years wound contamination class was the only factor that was well described for predicting the risk for SSI. During the Study on the Efficacy of Nosocomial Infection Control (SENIC) Project, an index was developed that provided a better assessment of the risk of SSIs than had the traditional wound classification system. In 1991, a modification of the SENIC risk index by Culver et al. led to the National Nosocomial Infections Surveillance (NNIS) System risk index. This review examines the best surveillance method for surgical site infection.

Occurrence of Surgical Site Infections at a Tertiary Healthcare Facility in Abuja, Nigeria: A Prospective Observational Study

“…Contamination of operated site has been reported to be the single most important factor determining the occurrence of SSI [ 10 ]. In contaminated and dirty wounds, contaminating pathogens were already present at the operating sites prior to commencement of the surgery [ 1 ]. Pre- and post-operative antibiotics therapies would have been expected to significantly reduce this threat to a level that can be effectively eliminated (inhibited or killed) by the activated host immune system [ 10 ].…”

“…Whilst surgical site infection (SSI) has been defined in various ways, the most widely used and accepted definition is the 1992 reclassification and definition by United States of America Centre for Disease Control and Prevention (CDC) which defined SSI as “an infection that occurs after surgery in the part of the body where the surgery took place within 30 days of an operative procedure or within one year if an implant is left in place” [ 1 , 2 ].…”

“…SSIs increase the length of postoperative hospital stay, escalate the cost of healthcare, increase the rate of hospital readmissions, and jeopardize health outcomes [ 3 ]. It is sometimes associated with considerable morbidity and occasional mortality [ 1 ]. Approximately ten additional days on the length of hospital stay have been attributed to SSIs [ 4 ].…”

One-Year Surveillance of Surgical Site Infections at a Tertiary Care Surgical Center in Egypt

“…Despite the advance in infection control practices such as adequate ventilation in operation room, barrier precautions and aseptic techniques, Infection at the surgical site remains as major source of morbidity and mortality following surgical procedures [3]. Continuous surveillance of SSI with periodic feedback of data to surgeons is considered an important preventive strategy to reduce the risk of SSI [4].…”

Prevalence of surgical site infections in general surgery in a tertiary care centre in Eastern India

“…For instance, a primary Incisional SSI involves the primary incision (e.g., chest incision for coronary artery bypass grafting), and a secondary Incisional SSI involves secondary incisions (e.g., leg incision for donor site in coronary artery bypass grafting). 3,4 The CDC wound classification system defines wound class based on risk and is divided into 4 categories:…”