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Surgical Site Infections

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Textbook of Emergency General Surgery

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Abstract

Surgical site infection (SSI) represents the most common postoperative complication after emergency surgery. It carries significant morbidity and mortality and is a major risk factor for further wound complications including dehiscence, evisceration, and incisional hernia caused by impaired wound healing. SSIs can be classified according to the anatomical plane infected, with different associated causative organisms depending on the anatomical plane involved as well as the nature of the emergency procedure. The diagnosis of SSI is made by clinical, microbiological, or radiological approaches, but many cases go unrecognised due to inadequate auditing structures. High-risk patients for SSI include older, frail patients, those functionally immunosuppressed, and those with impaired wound healing, whilst operative factors such as emergency surgery and in particular wound contamination also increase the risk of SSI. Various peri- and intra-operative strategies are available to reduce the risk of SSI. Treatment strategies for SSI include drainage of infection, debridement of tissue, and the appropriate use of antibiotics.

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Further Reading

  • Bhangu A, Ademuyiwa AO, Aguilera ML, Alexander P, Al-Saqqa SW, Borda-Luque G, Costas-Chavarri A, Drake TM, Ntirenganya F, Fitzgerald JE, Fergusson SJ. Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study. Lancet Infect Dis. 2018;18(5):516–25.

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  • De Simone B, Sartelli M, Coccolini F, Ball CG, Brambillasca P, Chiarugi M, Campanile FC, Nita G, Corbella D, Leppaniemi A, Boschini E. Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines. World J Emerg Surg. 2020;15(1):10.

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  • UK, NICE Guideline Updates Team. Surgical site infections: prevention and treatment. 2019.

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Authors and Affiliations

  1. Forth Valley Royal Hospital, Larbert, Scotland, UK

    A. Walker & M. Wilson

  2. University of Edinburgh, Edinburgh, Scotland, UK

    A. Walker

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  1. A. Walker
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  2. M. Wilson
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Correspondence to A. Walker .

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Editors and Affiliations

  1. General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Pisa, Italy

    Federico Coccolini

  2. General and Emergency Surgery Dept., Bufalini Hospital, Cesena, Italy

    Fausto Catena

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Walker, A., Wilson, M. (2023). Surgical Site Infections. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_115

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  • DOI: https://doi.org/10.1007/978-3-031-22599-4_115

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