Risk Factors for and Epidemiology of Surgical Site Infections

BACKGROUND: Surgical site infection (SSI) continues to be a major complication following operations. Identification of the frequency, the causative organisms, and the risk factors for infection still requires better definition. METHODS: Review of the current surgical literature was undertaken to define the epidemiology and risk factors associated with SSI. RESULTS: The rates of SSI continue to be reported with great variability, even for the same operation. Variable classification and definitions, inconsistent auditing, and an increase in post-discharge identification of infection are partially responsible for this variation. Understanding the role of the bacterial inocula and the response of the host leads to better utilization of preventive antibiotics and enhancement of host responsiveness (e.g., tissue warming). Better applications and studies of topical antiseptics need to be undertaken because of their long history of proved value. CONCLUSIONS: With a better understanding of the risk factors and epidemiology, effective preventive strategies can be utilized to reduce the current rates of SSI.