Surgical Site Infection Rate

Number of surgical site infections occurring within thirty days after the operative procedure if no implant is left in place or with one year if an implant is in place in patients who had an NHSN operative procedure performed during a specified time period and the infection appears to be related to the operative procedure. Infections are identified on original admission or upon readmission to the facility of original operative procedure within the relevant time frame (30 days for no implants; within 1 year for implants).

Two types of CDC-defined SSIs are included:
(1) A deep incisional SSI must meet the following criteria:
• Infection occurs within 30 days after the operative procedure if no implant is left or within one year if implant is in place and the infection appears to be related to the operative procedure
and
• involves deep soft tissues (e.g., fascial and muscle layers) of the incision
and
• patient has at least one of the following:
a) purulent drainage from the deep incision but not from the organ/space component of the surgical site
b) a deep incision spontaneously dehisces or is deliberately opened by a surgeon and is culture-positive or not cultured when the patient has at least one of the following signs or symptoms: fever (>38°C), or localized pain or tenderness. A culture-negative finding does not meet this criterion.
c) an abscess or other evidence of infection involving the deep incision is found on direct examination, during reoperation, or by histopathologic or radiologic examination
d) diagnosis of a deep incisional SSI by a surgeon or attending physician.

Note: There are two specific types of deep incisional SSIs:
1) Deep Incisional Primary (DIP) – a deep incisional SSI that is identified in a primary incision in a patient that has had an operation with one or more incisions (e.g., C-section incision or chest incision for CABG)
2) Deep Incisional Secondary (DIS) - a deep incisional SSI that is identified in the secondary incision in a patient that has had an operation with more than one incision (e.g., donor site [leg] incision for CBGB)

(2) An organ/space SSI must meet the following critieria:
• Infection occurs within 30 days after the operative procedure if no implant is left or within one year if implant is in place and the infection appears to be related to the operative procedure
and
• infection involves any part of the body, excluding the skin incision, fascia, or muscle layers, that is opened or manipulated during the operative procedure
and
• patient has at least one of the following:
a). purulent drainage from a drain that is placed through a stab wound into the organ/space
b). organisms isolated from an aseptically obtained culture of fluid or tissue in the organ/space
c). 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
d) diagnosis of an organ/space SSI by a surgeon or attending physician.

Specific sites of an organ/space SSI may be identified11