Plastic and Reconstructive Surgery
SSI (Surgical Site Infection) is a type of infection associated with hospital care. It usually appears within 30 days after a surgical procedure.
SSI is a real risk associated with every surgical procedure and it has a relevant influence on: morbidity and mortality of the patient. SSI also increases healthcare costs worldwide.
Factors having an influence on SSI
Many determinants affect on the correct healing of the wound and they therefore consequently affect the incidence of SSI. The level of bacterial contamination is the most influential risk factor. However modern surgical techniques and the use of prophylactic antibiotics have reduced this risk.
Surgical wounds are clasisified depending on the degree of bacterial contamination as follows:
- Clean
- Clean-contaminated
- Contaminated
- Dirty
Infection rate
With the protocolized use of antibiotherapy SSIs account for 20% of all infections associated with hospital care, the infection rate data provided by the U.S. National Nosocomial Infection Surveillance (NNIS) (1991) are:
- Clean wounds: 2.1%
- Clean-contaminated wounds: 3.3%
- Contaminated wounds: 6.4%
- Dirty wounds: 7.1%
Cost resulting from SSI
Studies carried out in europe up to 1998 have shown that the financial burden produced by SSi is caused primarily by increased hospital stay and there is an estimated average of 9,8 days with an average costs per day of 325 €.
(DiPiro JT, Martindale RG, Bakst A, Vacani PF, Watson P, Miller MT. Infection in surgical patients:effects on mortality, hospitalization and postdischarge care. AM J Health Syst Pharm 1998; 55(8): 777-781)
SSI rates
1. Superficial incisional SSI
Infection occurs within 30 days after surgery and affects the skin and subcutaneous planes.
2. Deep incisional SSI
The infection occurs within 30 days of procedure (or one year in the case of implants). It involves deep soft tissues such as fascia and muscles.
3. Organ/space SSI
The infection occurs within 30 days of procedure (or one year in the case of implants). The Infection involves any part of the anatomy (organs or cavities) other than the incision, which was opened or manipulated during an operation.