Chapter 23 – Surgical Site Infection
Donald E. Fry, MD
Adjunct Professor of Surgery
Northwestern University Feinberg School of Medicine
Chicago, Illinois
Professor Emeritus of Surgery
University of New Mexico School of Medicine
Albuquerque, New Mexico
Richard J. Howard, MD, PhD
The Robert J. and Kathleen M. Axline Professor of Surgery
University of Florida
Gainesville, Florida
ABSTRACT
Surgical site infection (SSI) continues to be a major source of morbidity, economic cost, and even deaths in surgical patients. SSIs occur as part of a complex interaction between the number of bacteria that contaminate the surgical site, the virulence of the contaminant, the microenvironment at the surgical site, and the integrity of host defense. Different surgical sites from different types of operations are at different risks for infection. Of importance, the acute and chronic medical conditions of the host become important variables in modulating the effectiveness of the host response, and hence the likelihood that infection will occur. The actual rate of SSI remains poorly defined because many procedures are performed on an outpatient basis, many infections in the inpatient population are not identified until after discharge, and the thoroughness of surveillance remains inconsistent. Multiple preventive measures, including the judicious use of preoperative antibiotics, have been demonstrated to reduce the frequency of SSI. Even with the use of all of the effective preventive measures, infections still occur and require effective management to minimize the consequences of the infection.
Last Revised: 12/13/09 2:23 PM
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