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Surgical Site Infections

Skin is a natural barrier against infection. Even with many precautions and protocols to prevent infection in place, any medical procedure that causes a break in the skin can lead to an infection. The medical terminology for these infections after surgery is surgical site infections (SSIs). If you undergo surgery, the chances of developing an SSI are about 1% to 3%, but this number can be more significant in specific surgical specialties and injuries such as cardiac surgery, ortho surgeries, and neuro surgeries.

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Types of Surgical Site Infections

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An SSI typically occurs within 30 days after surgery. The CDC describes three types of surgical site infections:
 

  • Superficial incisional SSI: occurs just in the area of the skin where the incision was made.

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  • Deep incisional SSI: occurs beneath the incision area in underlying muscle and the tissues surrounding the muscles.

 

  • Organ or space SSI: can be in any area of the body other than skin, muscle, and surrounding tissue that was involved in the surgery (including a body organ or a space between organs).

CDC: Centers for Disease Control and Prevention

Signs and Symptoms of Surgical Site Infections

Redness

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Fever

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Delayed Healing

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Tenderness

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Warmth & Swelling

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Any SSI may cause redness, fever, pain, delayed healing, tenderness, warmth, or swelling. These are the other signs and symptoms for specific types of SSI: 

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  • A superficial incisional SSI may produce pus from the wound site. Samples of the pus may be grown in a culture to find out the types of germs that are causing the infection. 

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  • A deep incisional SSI may also produce pus. The wound site may reopen on its own, or a surgeon may reopen the wound and find pus inside the wound.

 

  • An organ or space SSI may show a discharge of pus coming from a drain placed through the skin into a body space or organ. A collection of pus, called an abscess, is an enclosed area of pus and disintegrating tissue surrounded by inflammation. An abscess may be seen when the surgeon reopens the wound or by special X-ray studies.

Causes and Risk Factors of Surgical Site Infections

Infections after surgery are caused by germs. The most common of these include the bacteria Staphylococcus, Streptococcus, and Pseudomonas. Bacteria can infect a surgical wound through various forms of contact, such as from the touch of a contaminated caregiver or surgical instrument, through germs in the air, or through germs that are already on or in your body and then spread into the wound. 

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The degree of risk for an SSI is linked to the type of surgical wound you have. Surgical wounds can be classified in this way:​

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  • Clean wounds: not inflamed or contaminated and do not involve operating on an internal organ​

  • Clean-contaminated wounds: no evidence of infection at the time of surgery, but do involve operating on an internal organ.​

  • Contaminated wounds: involve operating on an internal organ with a spilling of contents from the organ into the wound.​

  • Dirty wounds: a known infection is present at the time of the surgery.

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Other risk factors for SSI:

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  • surgery that lasts more than 2 hours

  • other medical problems or diseases

  • being an elderly adult

  • overweight

  • smoking

  • cancer

  • a weak immune system

  • diabetes

  • emergency surgery

  • abdominal suergery

Helping Prevent Surgical Site Infections

Ask your doctor what you can do to reduce your risk for a surgical site infection. If you are having surgery, it's essential to stop smoking before surgery. Tell your surgical team about your medical history, especially if you have diabetes or another chronic illness. Avoid shaving in the skin area the surgeon plans to operate through.

Carefully follow your doctor's instructions about wound care after surgery. Avoid touching nor allow others to touch your wound or surgical site. Call your doctor if you develop a fever or pus, redness, heat, pain or tenderness near the wound, or any other signs or symptoms of a surgical site infection. ​

Treating Surgical Site Infections

Most superficial site infections can be treated with antibiotics. Sometimes, additional surgery or procedures may be required. During recovery, make sure that friends and family members wash their hands before and after they enter your room. Make sure your healthcare professionals wash their hands, too. 

© 2024 by PurusAgo, LLC

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