Current strategies for prevention of surgical site infections

Abstract

Surgical site infections (SSIs) are a common complication that follows all types of operative procedures. These infections are usually caused by the exogenous and endogenous microorganisms that enter the operative wound during the course of surgery. The general and procedure-specific risk factors for the development of SSI have been identified and are discussed in this article. Factors that influence the SSI rate and the current strategies for prevention of SSIs are also presented. Emphasis is placed on the efficacious use of antibiotic prophylaxis in surgery. A discussion of the principles of antibiotic prophylaxis, including choice of agents, route of administration, and timing, is offered. It appears that the use of less invasive laparoscopic surgical approaches, as practiced widely today, will be associated with an overall decreased incidence of SSI.

Pattern of pathogens from surgical wound infections in a Nigerian hospital and their antimicrobial susceptibility profiles

“…In spite of the progress in surgery, surgical techniques and antibiotic prophylaxis 1,2,3 , postoperative infections remain the commonest postoperative complications and one of the most frequently encountered nosocomial infections worldwide 4,5. The incidence of these infections has been estimated to be 15.45% and 11.32% by the Center for Disease Control and Prevention (CDC) USA and the UK Nosocomial Infection Surveillance respectively 6 . These infections lead to increase morbidity with the attendant increase in cost of therapy 7 .…”

“…The high incidence and prevalence of postoperative wound infections also result in increasing demand on the limited resources available to healthcare delivery eventually resulting in high degree of mortality 1,7 . As a result of these problems, routine surveillance for hospital acquired wound infections, including surgical wound infections, is recommended by both the CDC and the Surgical Infection Society in USA (SIS) 2,7 . Risk of wound infection varies with the type of surgery and surgical operations have been classified into, clean, clean-contaminated, contaminated and dirty 8,9 .…”

Isolation of Aerobic Bacteria from Surgical Site Infection and their Antibiotic Susceptibility Pattern

“…SSIs rate has varied from as low of 2.5% to a high of 41.9% 15 . In spite of the progress in the field of surgery, surgical technique and antibiotic prophylaxis, post-operative wound infection remain the commonest post-operative complications and one of the frequently encountered hospital acquired infection in the world wide 8 . This study gives an insight to the causative pathogens of post operative wound infections and their susceptibility patterns.…”

“…In fact most infection of post operative wound are hospital acquired and varies from one hospital to others [6][7][8] . Lack of standardized criteria for diagnosis of SSIs present a challenge to monitor the global epidemiology of surgical site infection 1 .…”

Current Approaches for the Prevention of Surgical Site Infections

“…According to the National Nosocomial Infections Surveillance (NNIS) System of the Centers for Disease Control and Prevention (CDC), SSIs account for 14 to 16% of all nosocomial infections and are the most common nosocomial infections among surgical patients, accounting for 38% of such infections [2] . Approximately 500,000 patients will acquire an SSI during the 44 million inpatient surgical procedures performed annually in the United States [3,4] . The prevalence of SSIs is a major concern because they increase the incidence of morbidity and mortality, length of hospitalization and cost of care for postoperative patients [3,4] .…”