Management of superficial and deep surgical site infection: an international multidisciplinary consensus
Clinical Scorecard: International Consensus on the Management of Superficial and Deep Surgical Site Infections
At a Glance
| Category | Detail |
|---|
| Condition | Superficial and deep incisional surgical site infections (SSI) |
| Key Mechanisms | Infection by commensal bacteria at surgical site, varying by procedure and pathogen resistance |
| Target Population | Patients undergoing surgery, especially emergency/intra-abdominal, immunosuppressed, obese, diabetic |
| Care Setting | Acute care hospitals and post-discharge outpatient settings |
Key Highlights
- SSI accounts for 18.4% of acute care-associated infections with significant mortality (~16,049 deaths/year).
- Risk varies by surgery type, patient factors (immunosuppression, obesity, diabetes), and pathogen resistance.
- 60.1% of SSIs occur after hospital discharge, complicating accurate surveillance.
Guideline-Based Recommendations
Diagnosis
- Use US CDC definitions for superficial and deep incisional SSIs; exclude organ/space infections.
- Employ patient self-assessment questionnaires post-discharge to improve detection.
- Rely on institutional infection surveillance data combined with clinical judgment.
Management
- Multidisciplinary team approach to stratify SSI risk and coordinate surgical and antimicrobial treatment.
- Tailor antimicrobial therapy based on local epidemiology and resistance patterns.
- Focus on prevention strategies especially in high-risk surgeries and patient populations.
Monitoring & Follow-up
- Implement institutional infection surveillance programs to reduce SSI rates.
- Monitor SSI incidence both during hospitalization and after discharge.
- Use validated questionnaires for post-discharge SSI assessment.
Risks
- Higher SSI risk in emergency and intra-abdominal surgeries involving hollow viscera penetration.
- Increased risk in immunosuppressed, obese, and diabetic patients.
- Antimicrobial-resistant pathogens increase hospitalization length and costs.
Patient & Prescribing Data
Surgical patients at risk of superficial and deep incisional SSIs, including high-risk groups
Antimicrobial therapy should be guided by local pathogen prevalence and resistance profiles; multidisciplinary input is essential.
Clinical Best Practices
- Engage a multidisciplinary team knowledgeable in local SSI epidemiology and antimicrobial resistance.
- Use standardized definitions and validated tools for SSI diagnosis and post-discharge surveillance.
- Prioritize prevention and early detection strategies tailored to surgery type and patient risk factors.
References
