Surgical Site Infection

Author(s):
Donald E. Fry, MD Adjunct Professor of Surgery

Northwestern University
Feinberg School of Medicine
Chicago, IL

Sonia N. Miller, EdD/CI, MSN, BSN, RN, CIC, FAPIC Manager for Infection Prevention & Control

Defense Health Agency (DHA) Infection Prevention and Control Program
DHHQ Clinical Quality Management/Medical Affairs/Patient Safety

Revised Publication:
March 18, 2025
Original Publication:
May 20, 2018
Declarations of Conflicts of Interest:
  • Donald E. Fry serves on the board of the Surgical Infection Foundation and is a past president of the organization. He is currently a member of 25 surgical societies and held no offices for any of these societies at the time of publication. He is editor-in-chief of the journal Surgical Infections. He speaks periodically on surgical infections for Becton Dickinson. He is a consultant to Prescient Surgical Co. (wound protector; stock options) and Melinta Therapeutics (new antibiotic; honorarium). He is a consultant and chairperson of the advisory board to the IrrlMax Company (honorarium; research funding) on the use of an application of dilute chlorhexidine in the surgical wound.
  • Sonia N. Miller reports no potential conflicts of interest.
Acknowledgments:

Special thanks to Dr. Donald E. Fry, MD, for drafting the original 2014 chapter and for revising it in 2020. 

Abstract

Surgical site infections (SSIs) can extend hospital stays and increase morbidity and mortality. Despite progression in infection prevention and control practices, SSIs remain a substantial cause of adverse events for patients. The risk for SSIs depends on the quantity of microorganisms that contaminate the surgical site, the virulence of the contaminants, conditions in the immediate environment surrounding the surgical site or wound, and the integrity of the host defenses. Multiple preventive measures, including the judicious use of preoperative antimicrobials, have been demonstrated to reduce the frequency of SSIs. When SSIs occur, effective management is required to minimize the consequences. Because SSIs can occur after hospital discharge or during ambulatory procedures, infection preventionists across the continuum of care should stay informed of evidence-based guidelines and surveillance methods for SSIs.