Surgical Site Infection (SSI)

 

SSI (Surgical Site Infection)

SSI is further divided into

1. A superficial incisional SSI
2. A deep incisional SSI
3. An organ/space SSI

 

1. A superficial incisional SSI must meet one of the following criteria:

• Infection occurs within 30 days after the operative procedure

And

• involves only skin and subcutaneous tissue of the incision

And

• patient has at least one of the following:

a)    Purulent drainage from the superficial incision.

b)    Organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision.

c)     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, and is culture-positive or not cultured. A culture-negative finding does not meet this criterion.

d)    Diagnosis of superficial incisional SSI by the surgeon or attending physician.

 

NOTE: There are two specific types of superficial incisional SSIs:

1. Superficial Incisional Primary (SIP) – a superficial incisional SSI that is identified in the primary incision in a patient that has had an operation with one or more incisions (e.g., C-section incision or chest incision for CBGB)

2. Superficial Incisional Secondary (SIS) – a superficial incisional SSI that is identified in the secondary incision in a patient that has had an operation with more than one incision (e.g., donor site [leg] incision for CBGB)

2.     A deep incisional SSI must meet one of the following criteria:

• Infection occurs within 30 days after the operative procedure if no implant is left in place or within one year if implant is in place and the infection appears to be related to the operative procedure

And

• Involves deep soft tissues (e.g., fascial and muscle layers) of the incision

And

• patient has at least one of the following:
• Purulent drainage from the deep incision but not from the organ/space component of the surgical site
• A deep incision spontaneously dehisces or is deliberately opened by a surgeon and is culture-positive or not cultured and the patient has at least one of the following signs or symptoms: fever (>38°C), or localized pain or tenderness. A culture-negative finding does not meet this criterion.
• An abscess or other evidence of infection involving the deep incision is found on direct examination, during reoperation, or by histopathologic or radiologic examination
• Diagnosis of a deep incisional SSI by a surgeon or attending physician.

 

3. An organ/space SSI must meet one of the following criteria:

• Infection occurs within 30 days after the operative procedure if no implant is left in place or within one year if implant is in place and the infection appears to be related to the operative procedure

And

• Infection involves any part of the body, excluding the skin incision, fascia, or muscle layers, that is opened or manipulated during the operative procedure

And

• Patient has at least one of the following:

a)    purulent drainage from a drain that is placed through a stab wound into the organ/space

b)    organisms isolated from an aseptically obtained culture of fluid or tissue in the organ/space

c)     an abscess or other evidence of infection involving the organ/space that is found on direct examination, during reoperation, or by histopathologic or radiologic examination

d)    diagnosis of an organ/space SSI by a surgeon or attending physician.