Management of Surgical Site Infections

Abstract

According to the Centers for Disease Control (CDC), there were 16 million operative procedures performed in the USA in 2010 (CDC, Data from the National Hospital Discharge Survey [Online], http://www.cdc.gov/nchs/data/nhds/4procedures/2010pro_numberpercentage.pdf, 2010). The following year there were over 157,000 surgical site infections (SSI) associated with inpatient surgeries alone (Magill, N Engl J Med 370:1198–208, 2014). The overall rate of SSI has been found to be about 2 % though it has been difficult to quantify directly. Many agencies have taken a keen interest in reducing the rate of SSI given that they lead to increased health care costs, morbidity, mortality, and length of hospitalization. Despite efforts to institute protocols that are aimed at reducing SSIs, adherence to such protocols remains inconsistent. The rate of SSI mortality is thought to be about 3 % (Awad, Surg Infect 13:234–7, 2012). In addition, patients who suffer from SSI are twice as likely to require intensive care unit (ICU) admission and five times as likely to need hospital re-admission (Kirkland et al., Infect Control Hosp Epidemiol 20:725–30, 1999). In real terms, SSIs constitute a significant public health problem with substantial detriment to the patient, hospital systems, and the health care system as a whole.