The New CDC-definitions for surveillance of surgical site infections (1992)
take into account 3 classes of surgical site infections (SSI) : superficia
l and deep incisional SSI, and organ/space SSI. The most important host-rel
ated risk factors for development of SSI are advanced age, morbid obesity,
disease severity, an ASA score > 2, prolonged preoperative hospital stay, a
nd infection at distal sites. Microbial contamination of the surgical site
occurs mainly during the surgical intervention. Although exogenous contamin
ation may be of concern, especially in clean operations, most surgical site
infections are caused by microorganisms of the patient's own commensal flo
ra. SSI rates vary according to the type and duration of the surgical proce
dure and the skill of the surgeon. Proper surgical technique is the most im
portant factor in the prevention of SSI. Modification of host risk factors
should be attempted whenever possible. In addition, adequate protocols for
antimicrobial prophylaxis with antibiotics should be followed. Surveillance
of surgical site infections is probably beneficial for SSI prevention.