112 - Surgical Prophylaxis

Summary

The prevention of surgical site infection (SSI) remains a focus of attention because wound infections continue to be a major source of expense, morbidity, and even mortality. A patient who develops a wound infection while still hospitalized has an approximately 60% greater risk of being admitted to the intensive care unit, and an attributable extra hospital stay of 6.5 days, at an additional direct cost of $3000. Risk of readmission within 30 days is 5 times more likely for infected patients, at a cost of more than $5000.

The epidemiologic data testifying to the significance of SSI are overwhelming. SSIs are the third most frequently reported nosocomial infection, accounting for 14% to 16% of nosocomial infections in hospitalized patients. Approximately 40% of nosocomial infections occurring among surgical patients are SSIs, two thirds of which affect the incision and one third involve organ/space infection. Three quarters of deaths of surgical patients with SSI are attributed to that infection, nearly all of which are organ/space infections. Because of the importance of these infections following operation, considerable effort has been expended to identify other potentially controllable variables that influence infection rates. A major review of this subject and an extensive list of recommendations for preoperative patient preparation and operating room environment have recently been published by the Hospital Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC).