Surgical Site Infections Essay

Surgical site infections (SSIs) are frequent and serious complications of surgical procedures. They are associated with a prolonged duration of hospitalization, readmissions, re-interventions and the patient may suffer from permanent disability or even death.1

SSIs are probably the most preventable of the health care-associated infections. Despite the widespread international introduction of level I evidence-based guidelines for the prevention of SSIs, such as that of the National Institute for Clinical Excellence (NICE) in the UK and the surgical care improvement project (SCIP) of the USA, SSI rates have not measurably fallen. The care bundle approach is an accepted method of packaging best, evidence-based measures into routine care for all patients and, common to many guidelines for the prevention of SSI, includes methicillin resistant Staphylococcus aureus (MRSA) screening (in high risk operations as cardiac surgeries, orthopedic surgeries and neuro surgeries), methods for preoperative removal of hair (where appropriate), rational antibiotic prophylaxis, effective skin preparation, avoidance of perioperative hypothermia, and management of perioperative blood glucose. 2

Superficial and deep post-sternotomy infections are relatively frequent complications after cardiac surgery and are associated with substantial

fascial and muscle layers) of the incision. At least one of the following must also be present: • Purulent drainage from the deep incision but not from the organ or space component of the surgical site. • Wound dehisces or is deliberately opened by the surgeon when the patient has one of the following: fever (>38oC) or localized pain or tenderness, unless the site is culture negative. • An abscess or other sign of deep infection is found by radiological examination, direct examination, during re-operation or by