The “Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals” protocol adopts the following definition of Surgical Site Infection (SSI).

 

Superficial incisional (SSI-S):

infection occurs within 30 days after the operation and infection involves only skin and subcutaneous tissue of the incision and at least one of the following:

-       purulent drainage with or without laboratory confirmation, from the superficial incision;

-       organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision;

-       at least one of the following signs or symptoms of infection: pain or tenderness, localised swelling, redness, or heat, and superficial incision is deliberately opened by surgeon, unless incision is culture-negative;

-       diagnosis of superficial incisional SSI made by a surgeon or attending physician.

 

Deep incisional (SSI-D):

infection occurs within 30 days after the operation if no implant is left in place, or within one year if implant is in place and the infection appears to be related to the operation and infection involves deep soft tissue (e.g. fascia, muscle) of the incision and at least one of the following:

-       purulent drainage from the deep incision but not from the organ/space component of the surgical site;

-       a deep incision spontaneously dehisces or is deliberately opened by a surgeon when the patient has at least one of the following signs or symptoms: fever (> 38 °C), localised pain or tenderness, unless incision is culture-negative;

-       an abscess or other evidence of infection involving the deep incision is found on direct examination, during reoperation, or by histopathologic or radiologic examination;

-       diagnosis of deep incisional SSI made by a surgeon or attending physician.

 

Organ/ space (SSI-O):

infection occurs within 30 days after the operation if no implant is left in place, or within one year if implant is in place and the infection appears to be related to the operation and infection involves any part of the anatomy (e.g. organs and spaces) other than the incision which was opened or manipulated during an operation, and at least one

of the following:

-       purulent drainage from a drain that is placed through a stab wound into the organ/space;

-       organisms isolated from an aseptically obtained culture of fluid or tissue in the organ/space;

-       an abscess or other evidence of infection involving the organ/space that is found on direct examination, during reoperation, or by histopathologic or radiologic examination;

-       diagnosis of organ/space SSI made by a surgeon or attending physician.

 

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Link to European IC/HH Core Competencies

Area 3. Surveillance and investigation of healthcare associated infection (HAI)

 

References

http://www.ecdc.europa.eu/en/publications/Publications/0512-TED-PPS-HAI-antimicrobial-use-protocol.pdf
ECDC