Surgical site infections

The New CDC-definitions for surveillance of surgical site infections (1992) take into account 3 classes of surgical site infections (SSI) : superficial and deep incisional SSI, and organ/space SSI. The most important host-related risk factors for development of SSI are advanced age, morbid obesity, disease severity, an ASA score > 2, prolonged preoperative hospital stay, and infection at distal sites. Microbial contamination of the surgical site occurs mainly during the surgical intervention. Although exogenous contamination may be of concern, especially in clean operations, most surgical site infections are caused by microorganisms of the patient's own commensal flora. SSI rates vary according to the type and duration of the surgical procedure and the skill of the surgeon. Proper surgical technique is the most important factor in the prevention of SSI. Modification of host risk factors should be attempted whenever possible. In addition, adequate protocols for antimicrobial prophylaxis with antibiotics should be followed. Surveillance of surgical site infections is probably beneficial for SSI prevention.