Surgical Site Infection (SSI)

What is a Surgical Site Infection (SSI)?

A surgical site infection (SSI) can occur after surgery either directly at the site of the incision or in the region of the body where the surgery took place. Microorganisms from your own body or from the environment can enter the body through the incision made by the surgeon during or after the operation. Most patients who have surgery do not develop an infection. Some of the common symptoms of a surgical site infection are:

• Fever
• Redness and pain around the area where you had surgery
• Increased swelling that goes past the wound area and does not go away after five days
• Drainage of cloudy fluid from your surgical wound (It is normal to have a small amount of draining from the wound for the first day or two after surgery)

Can SSIs be treated?

Most surgical site infections can be treated with antibiotics. The antibiotic prescribed depends on the bacteria causing the infection since different antibiotics are active against different organisms. A patient’s health care team will likely take samples from the infected wound to determine what antibiotic should be used. In some cases, the infection may require additional surgery, particularly if deeper tissue is affected by the infection.

What are some of the things that hospitals are doing to prevent SSIs?

• Clean their hands and arms up to their elbows with an antiseptic agent directly before starting the surgery.
• Clean their hands with soap and water or an alcohol-based hand rub before and after caring for each patient.
• If it is necessary to remove hair at the area the surgery is to take place, electric clippers with a disposable head should be used. They should not shave you with a razor.
• Health care professionals must wear special hair covers, masks, gowns, and gloves during surgery to keep the surgery area clean.
• If the patient or procedure presents greater risk for infection, the patient should be given antibiotics before surgery starts. In most cases, the patient should get antibiotics within 60 minutes before the surgery starts.
• Clean the skin at the site of your surgery with a special soap that kills germs.

What can I do to help prevent an SSI?

Before your surgery:

• How likely am I to get an infection?
• Do infections often occur after this type of operation?
• What steps will be taken before my operation to help prevent infection?
• Am I likely to need antibiotics for this operation?

• Tell your doctor about other medical problems you may have. Health problems such as allergies, diabetes and obesity could affect your surgery and your treatment. Bring an up-to-date list of all your medications amd talk with your surgeon about why you take each medication.
• Patients who smoke get more infections. If you smoke, talk to your doctor about quitting before your surgery.
• If possible, any existing infections should be treated prior to undergoing surgery.
• Do not shave near where you will have surgery. Shaving with a razor can irritate your skin and make it easier to develop an infection.

• Speak up if someone tries to shave you with a razor before surgery. Ask why you need to be shaved and talk with your surgeon if you have any concerns.
• Ask if you will get antibiotics before surgery.

After your surgery:

• What can I do to help prevent my wound from becoming infected?
• How do I know if my wound is infected?
• How often should I check my wound and for how long after my operation?
• What should I do if my wound does become infected?
• Who can I contact for advice?
• What treatment will I need if I have a surgical site infection?

• Make sure that your health care providers clean their hands before and after examining you, with either soap and water or an alcohol-based hand sanitizer.
• Health care providers must take extra precaution when changing and cleaning the wound dressing. Sterile saline should be used to cleanse your wound during the first 48 hours after your operation.
• Family and friends who visit you should not touch the surgical wound or dressings.
• Family and friends should clean their hands with soap and water or an alcohol-based hand sanitizer before and after visiting you. If you do not see them clean their hands, ask them to clean their hands.

What do I need to do when I go home from the hospital?

• Before you go home, your doctor or nurse should explain how to take care of your wound. Make sure you understand how to care for your wound before you leave the hospital.
• Always clean your hands before and after caring for your wound. Carefully and frequently wash your hands with soap and water by scrubbing them briskly for at least 15 seconds.
• Before you go home, make sure you know who to contact if you have questions or problems after you get home.
• If you have any symptoms of an infection, such as redness and pain at the surgery site, drainage, or fever, call your doctor immediately.