• Surgical Site Infection

    (SSI; Surgical Wound Infection)

    Definition

    A surgical site infection (SSI) is an infection in the area where surgery was done. Most SSIs involve the skin, but sometimes deep tissue or organs can become infected.
    The sooner a surgical site infection is treated, the better the outcome.
    Surgical Site Infection Near the Ankle
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    SSIs are caused by bacteria.

    Risk Factors

    Factors that may increase your chance an SSI are:
    • Poor blood circulation
    • Prior infection
    • Trauma
    • Foreign body in the wound, like a surgical mesh used for a hernia repair
    • Smoking
    • Diabetes
    • Obesity
    • Long-term medical conditions
    • Heart disease
    • Lung disease
    • Weakened immune system
    • Age (elderly and very young)

    Symptoms

    An SSI may cause:
    • Fever more than 100.5ºF 48 hours or more after surgery
    • Chills
    • Fast heart rate
    • Chest pain
    • Symptoms in the area where the surgery took place:
      • Redness
      • Drainage
      • Pus
      • Pain
      • Swelling
      • Bad smell

    Diagnosis

    Your doctor will ask about your symptoms and medical history, and look at your wound.
    Tests may include the following:
    • Wound culture—to test for bacteria in the wound
    • Biopsy—removal of a small piece of tissue from the wound to test for bacteria
    • Ultrasound or CT scan—to look for infection in the wound and nearby areas

    Treatment

    Treatment options include:

    Antibiotics

    Bacterial infections can be treated with antibiotics. The kind of antibiotic you will get depends on the bacteria causing the infection. You may be given antibiotics by IV or by mouth.

    Surgery

    You may need surgery to clean out the infection from your wound. Your doctor will reopen the wound. It may be flushed with sterile fluid and drained of pus.

    Dressing

    Your doctor may order a special dressing to help your wound heal.

    Prevention

    To help reduce your chance of an SSI, your doctor may do the following:
    • Give you an antibiotic before, during, and after surgery.
    • Ask you to lose weight or stop smoking.
    • Show you how to wash your skin with an antiseptic soap before your surgery.
    • Give you instructions on how to care for your incision at home—It is important to follow your doctor’s instructions.

    RESOURCES

    American College of Surgeons https://www.facs.org

    Centers for Disease Control https://www.cdc.gov

    CANADIAN RESOURCES

    Canadian Society of Plastic Surgeons http://plasticsurgery.ca

    Wounds Canada https://www.woundscanada.ca

    References

    Healthcare-associated infections (HAI). Centers for Disease Control website. Available at: https://www.cdc.gov/hai. Updated July 14, 2017. Accessed September 5, 2017.

    Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10-e52.

    Surgical site infection—prevention. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T316886/Surgical-site-infection-prevention. Updated February 7, 2017. Accessed September 5, 2017.

    Revision Information

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