Surgical site infection (SSI)

Surgical site infections are a form of healthcare-associated or nosocomial infection. With a share of approximately 22 per cent, SSI are the second most common nosocomial infections in Germany, also because the number of surgical procedures continues to rise. In low- and middle-income countries, SSI is the most common form of nosocomial infection, according to the WHO. SSI frequently only affect the superficial tissues, but if the infections are more serious they can affect the deeper tissues or other parts of the body manipulated during the procedure. The majority of SSI become apparent within 30 days of a surgical procedure and most often between the 5th and 10th postoperative days. However, where a prosthetic implant is used, SSI affecting the deeper tissues may occur several months after the operation. The CDC definition describes three levels of SSI:

  • superficial incisional, affecting the skin and subcutaneous tissue. These infections may be indicated by localised (Celsian) signs such as redness, pain, heat or swelling at the site of the insicion or by the drainage of pus.
  • deep incisional, affecting the fascial and muscle layers. These infections may be indicated by the presence of pus or an abcess, fever with tenderness of the wound, or a separation of the edges of the incision exposing the deeper tissues.
  • organ or space infection, which involves any part of the anatomy other than the incision that is opened or manipulated during the surgical procedure, for example joint or peritoneum. A number of pre-, intra- and postoperative measures help to reduce SSI rates – an overview can be found here.
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