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21 - Prevention of surgical site infections

Published online by Cambridge University Press:  12 January 2010

By
Hien H. Nguyen  and
Stuart H. Cohen
Edited by
Michael F. Lubin ,
Robert B. Smith ,
Thomas F. Dodson ,
Nathan O. Spell  and
H. Kenneth Walker
Hien H. Nguyen
Affiliation:
Division of Infectious Diseases, University of California, Davis School of Medicine, Sacramento, CA
Stuart H. Cohen
Affiliation:
Division of Infectious Diseases, University of California, Davis School of Medicine Sacramento, CA
Michael F. Lubin
Affiliation:
Emory University, Atlanta
Robert B. Smith
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Nathan O. Spell
Affiliation:
Emory University, Atlanta
H. Kenneth Walker
Affiliation:
Emory University, Atlanta
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Summary

Introduction

Prevention of surgical infections has helped to revolutionize surgery from a practice that had been plagued by frequent infection and death into the discipline it is today. As the development of antimicrobial prophylaxis and the prevention of postoperative infection have progressed, the development of more invasive, technical procedures has also evolved.

However, infections related to surgery continue to remain a problem. Over 27 million surgeries are performed in US hospitals each year with average infection rates over the past decade ranging from 0.14% for clean uncomplicated eye surgery to well over 17% for high-risk cardiothoracic surgeries, with an overall infection rate of approximately 2.6% from 1986–1996. Data from the Centers for Disease Control and Prevention (CDC), through the National Nosocomial Infections Surveillance (NNIS) System, indicate surgical site infections (SSIs) are the third most common infection reported, accounting for 14%–16% of all nosocomial infections. SSIs are the most common nosocomial infection in surgical patients. In turn, these complications result in longer and costlier hospital stays. In 1995, it was estimated that nosocomial infections accounted for approximately $4.5 billion of the healthcare budget, with surgical wound infections the most costly. In fact, when readmissions are accounted, Kirkland and colleagues estimated in 1999 that the total excess hospitalization and direct costs attributable to one surgical site infection were 12 additional hospital days and $5038, respectively.

For some procedures, SSIs not only impact cost but also quality of life.

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
 , pp. 285 - 306
Publisher: Cambridge University Press
Print publication year: 2006

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