Abstract
Surgical site infection (SSI) occurs in 2–5 % of patients who have inpatient operations. This complication can result in major morbidity and in its more serious forms, even death. Understanding the pathogenesis and microbiology of SSI is important in order to identify strategies for prevention. There are a number of controllable and modifiable risk factors that influence the occurrence of SSI and must be recognized and addressed in order to minimize the occurrence of this complication. The proper use of perioperative antimicrobial prophylaxis (PAP) is one of the most important measures that when used in combination with other proven measures can lower the incidence of SSI. However, it cannot make up for failure to adhere to the many other principles of prevention. Treatment of superficial SSI is relatively simple; however, deep and organ/space SSI can be challenging and can result in major morbidity and death.
This chapter will provide information on the definition, pathogenesis, and microbiology of SSI. Risk factors are identified and the principles of PAP presented. Finally, the principles of treatment of SSI are presented.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Barie PS. Surgical site infections: epidemiology and prevention. Surg Infect (Larchmt). 2002;3 Suppl 1:S9–21.
Horan TC, Gaynes RP, Martone WJ, et al. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992;13:606–8.
Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36:309–32.
Livingston DH, Malangoni MA. An experimental study of susceptibility to infection after hemorrhagic shock. Surg Gynecol Obstet. 1989;168:138–42.
Latham R, Lancaster AD, Covington JF, et al. The association of diabetes and glucose control with surgical-site infections among cardiothoracic surgery patients. Infect Control Hosp Epidemiol. 2001;22:607–12.
Zerr KJ, Furnary AP, Grunkemeier GL, et al. Glucose control lowers the risk of wound infection in diabetics after open heart operations. Ann Thorac Surg. 1997;63:356–61.
Nagachinta T, Stephens M, Reitz B, et al. Risk factors for surgical wound infection following cardiac surgery. J Infect Dis. 1987;156:967–73.
Vinton AL, Traverso LW, Jolly PC. Wound complications after modified radical mastectomy compared with tylectomy with axillary lymph node dissection. Am J Surg. 1991;161:584–8.
National Nosocomial Infections Surveillance System (NNIS) System Report, Data summary from January 1992–June 2001, issued August 2001. Am J Infect Control. 2001;29:404–21.
Haridas M, Malangoni MA. Predictive factors for surgical site infection in general surgery. Surgery. 2008;144:496–503.
Edmiston Jr CE, Lee CJ, Krepel CJ, et al. Evidence for a standardized preadmission showering regimen to achieve maximal antiseptic skin surface concentrations of chlorhexidine gluconate, 4%, in surgical patients. JAMA Surg. 2015;150:1027–33.
Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect (Larchmt). 2013;14:73–156.
Kiran RP, Murray AC, Chiuzan C, et al. Combined preoperative mechanical bowel preparation with oral antibiotics significantly reduces surgical site infection, anastomotic leak, and ileus after colorectal surgery. Ann Surg. 2015;262:416–25.
Harbarth S, Samore MH, Lichtenberg D, et al. Prolonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance. Circulation. 2000;101:2916–21.
Bozorgzadeh A, Pizzi WF, Barie PS, et al. The duration of antibiotic administration for penetrating abdominal trauma. Am J Surg. 1999;177:125–31.
Bratzler DW, Houck PM, Richards C, et al. Use of antimicrobial prophylaxis for major surgery. Baseline results from the National Surgical Infection Prevention Project. Arch Surg. 2005;140:174–82.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Malangoni, M.A. (2017). Surgical Site Infections and Their Management. In: Di Saverio, S., Catena, F., Ansaloni, L., Coccolini, F., Velmahos, G. (eds) Acute Care Surgery Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-15341-4_10
Download citation
DOI: https://doi.org/10.1007/978-3-319-15341-4_10
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-15340-7
Online ISBN: 978-3-319-15341-4
eBook Packages: MedicineMedicine (R0)