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Definition

A surgical site infection (SSI) is an infection in the area where surgery was done. Most SSIs involve the skin, but sometimes deep tissue or organs can become infected.

The sooner a surgical site infection is treated, the better the outcome.

Surgical Site Infection Near the Ankle
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Causes

SSIs are caused by bacteria.

Risk Factors

Factors that may increase your chance an SSI are:

  • Poor blood circulation
  • Prior infection
  • Trauma
  • Foreign body in the wound, like a surgical mesh for hernia repair
  • Smoking
  • Diabetes
  • Overweight or obese
  • Long-term medical conditions
  • Heart disease
  • Lung disease
  • Weakened immune system
  • Age (elderly and very young)

Symptoms

An SSI may cause:

  • Fever more than 100.5ºF 48 hours or more after surgery
  • Chills
  • Fast heart rate
  • Chest pain
  • Symptoms in the area where the surgery took place:
    • Redness
    • Drainage
    • Pus
    • Pain
    • Swelling
    • Bad smell

Diagnosis

Your doctor will ask about your symptoms and medical history, and look at your wound.

Tests may include the following:

  • Wound culture—to test for bacteria in the wound
  • Biopsy—removal of a small piece of tissue from the wound to test for bacteria
  • Ultrasound or CT scan—to look for infection in the wound and nearby areas

Treatment

Treatment options include:

Antibiotics

Bacterial infections can be treated with antibiotics. The kind of antibiotic you will get depends on the bacteria causing the infection. You may be given antibiotics by IV or by mouth.

Surgery

You may need surgery to clean out the infection from your wound. Your doctor will reopen the wound. He may flush it with sterile fluid, drain it of pus, and remove infected areas.

Dressing

Your doctor may order a special dressing to help your wound heal.

Prevention

To help reduce your chance of an SSI, your doctor may do the following:

  • Give you an antibiotic before, during, and after surgery.
  • Ask you to lose weight or stop smoking .
  • Show you how to wash your skin with an antiseptic soap before your surgery.
  • Give you instructions on how to care for your incision at home—It is important to follow your doctor’s instructions.

Revision Information

  • American College of Surgeons

    http://www.facs.org

  • Centers for Disease Control

    http://www.cdc.gov

  • Canadian Association of Wound Care

    http://www.cawc.net

  • The Canadian Society of Plastic Surgeons

    http://www.plasticsurgery.ca

  • Healthcare-associated infections (HAI). Centers for Disease Control website. Available at: http://www.cdc.gov/hai. Updated March 26, 2014. Accessed September 30, 2014.

  • Stevens DL, Bisno AL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10-e52.

  • Surgical site infection. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 14, 2014. Accessed September 30, 2014.

  • Surgical site infection—prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 29, 2014. Accessed September 30, 2014.