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The prevention of surgical site infection (SSI) remains a focus of attention because such infections continue to be a major source of expense, morbidity, and even mortality. SSIs are the third most frequently reported nosocomial infection, accounting for 14% to 16% of nosocomial infections in hospitalized patients. Approximately 40% of healthcare-associated infections occurring among surgical patients are SSIs. A patient who develops a surgical site infection while still hospitalized has an approximately 60% greater risk of being admitted to the intensive care unit, and an attributable extra hospital stay of 6.5 days, at an additional direct cost of $3000. Risk of readmission within 30 days is five times more likely for infected patients, at a cost of more than $5000.
Depending on the procedure, between one-half and two-thirds of SSIs affect the incision and the remainder involve deep tissue or organ/space infection. Nearly all deep and organ/space SSIs require hospitalization, operative or radiologic intervention, and intravenous antibiotic therapy. These are the most expensive healthcare-associated infections. Three-quarters of deaths of surgical patients with SSI are attributed to that infection, nearly all of which are organ/space infections. Conversely, superficial incisional infections commonly are noted after discharge, rarely require rehospitalization or intervention, and have little if any documented social or financial cost. The National Healthcare Safety Network no longer publicly reports superficial incisional infection rates.
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