Guideline for Prevention of Surgical Site Infection, 1999 ☆ ☆☆ ★ ★★

The “Guideline for Prevention of Surgical Site Infection, 1999” presents the Centers for Disease Control and Prevention (CDC)'s recommendations for the prevention of surgical site infections (SSIs), formerly called surgical wound infections. This two-part guideline updates and replaces previous guidelines.Part I, “Surgical Site Infection: An Overview,” describes the epidemiology, definitions, microbiology, pathogenesis, and surveillance of SSIs. Included is a detailed discussion of the pre-, intra-, and postoperative issues relevant to SSI genesis.

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Guideline for Prevention of Surgical Site Infection, 1999

https://www.amjmed.com/article/0002-9343(91)90361-Z/pdf

Surgical wound infection rates by wound class, operative procedure, and patient risk index

An estimated 2 million patients develop nosocomial infections in the United States annually. The increasing number of antimicrobial agent-resistant pathogens and high-risk patients in hospitals are challenges to progress in preventing and controlling these infections. While Escherichia coli and Staphylococcus aureus remain the most common pathogens isolated overall from nosocomial infections, coagulase-negative staphylococci (CoNS), organisms previously considered contaminants in most cultures, are now the predominant pathogens in bloodstream infections. The growing number of antimicrobial agent-resistant organisms is troublesome, particularly vancomycin-resistant CoNS and Enterococcus spp. and Pseudomonas aeruginosa resistant to imipenem. The active involvement and cooperation of the microbiology laboratory are important to the infection control program, particularly in surveillance and the use of laboratory services for epidemiologic purposes. Surveillance is used to identify possible infection problems, monitor infection trends, and assess the quality of care in the hospital. It requires high-quality laboratory data that are timely and easily accessible.

An overview of nosocomial infections, including the role of the microbiology laboratory.

Introduction:
Surgical site infection (SSI) is a potentially morbid and costly complication following major colorectal resection. In recent years, there has been growing attention placed on the accurate identification and monitoring of such surgical complications and their costs, measured in terms of increased morbidity to patients and increased financial costs to society. We hypothesize that incisional SSIs following elective colorectal resection are more frequent than is generally reported in the literature, that they can be predicated by measurable perioperative factors, and that they carry substantial morbidity and cost.

Wound infection after elective colorectal resection.

• During a 10-year wound infection surveillance program, 1032 wound infections complicated 40 915 operations. Surveillance continued for 30 days postoperatively, and rigid clinical criteria for diagnosis were honored. Operations were distributed unequally among infection risk classes: clean (class I), 63.3%; clean contaminated (class II), 26.4%; and contaminated (class III) 10.3%. Infections occurred with nearly equal frequencies among classes: I, 36.1%; II, 29.5%; and III, 34.4%. Wound infection rates during the 10-year period were 2.5% (all operations), 1.4% (class I), 2.8% (class II), and 8.4% (class III). Index year (1977) infection rates were 4.2% (all operations), 2.3% (class I), 5.4% (class II), and 12.8% (class III). Wound infection rates during the last 9 years of surveillance in every risk class were significantly less than index year rates, representing infection rate decreases of 38% to 56%. Estimated savings in hospital room costs alone reached $3 million during 10 years. (Arch Surg. 1990;125:794-803)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=SURG&articleId=594699&pdfFileName=archsurg_125_6_020.pdf

Continuous, 10-year wound infection surveillance. Results, advantages, and unanswered questions.

The moderator for this discussion was Robert E. Condon, MD, from Milwaukee, and the panelists were Robert W. Haley, MD, from Dallas; James T. Lee, Jr, MD, PhD, from Minneapolis; and Jonathan L. Meakins, MD, from Montreal. Dr Condon: The issue is whether present methods of hospital epidemiology really have an impact on surgical wound infections and other surgically related infections. Inother words, do our present methods of "infection control" work effectively in controlling surgical infections, in deriving reliable data, and in informing the surgical staff? I think the answers to these questions are largely negative. The panelists are a distinguished group, an epidemiologist and two surgeons with special interest and expertise in this arena. The first panelist is Robert W. Haley, MD, associate professor of medicine and epidemiology at the University of Texas Southwestern Medical School in Dallas. He formerly was director of the Hospital Infection Program of the

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=SURG&articleId=592981&pdfFileName=archsurg_123_2_019.pdf

James T. Lee

Papers

Continuous, 10-year wound infection surveillance. Results, advantages, and unanswered questions.

Does infection control control infection

Continuous, 10-Year Wound Infection Surveillance: Results, Advantages, and Unanswered Questions