Carl R. Darnall Army Medical Center - Health Library

Surgical Site Infection

(SSI; Surgical Wound Infection)

Definition

A surgical site infection (SSI) is an infection linked to recent surgery. Most SSIs involve just the skin. Some may infect deep tissue or organs.

The sooner an SSI is treated, the better the outcome.

Surgical Site Infection Near the Ankle
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Causes ^

Bacteria are the most common cause of SSIs.

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 past heath. Your wound will be checked.

Tests may include the following:

  • Wound culture—to test for bacteria in the wound
  • Biopsy—a small piece of tissue is removed to test for bacteria
  • Ultrasound or CT scan—to look for infection in the wound and nearby areas

Treatment ^

Treatment options include:

  • Antibiotics—may be given as pills or through IV
  • Surgery—to clean out the infection
    • The wound may need to be reopened.
    • It can be flushed with fluid to clean out pus.
  • Special dressing—to help keep area dry and clean

Prevention ^

To help reduce your chance of an SSI, your doctor may recommend the following:

  • An antibiotic just before surgery
  • Antibiotics if there were signs of an infection at time of surgery
  • Lose weight before the surgery
  • Stop smoking
  • Wash your skin with an antiseptic soap before your surgery
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 September 4, 2018. Accessed October 2, 2018.

Suspected surgical site infection - approach to the patient. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T922624/Suspected-surgical-site-infection-approach-to-the-patient. Updated August 20, 2018. Accessed October 2, 2018.

Last reviewed September 2018 by EBSCO Medical Review Board Donald W. Buck II, MD  Last Updated: 10/2/2018