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Surgical Site Infection (SSI) : CDC Definitions Simplified

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Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999 Apr;27(2):97-132; quiz 133-4; discussion 96. PMID: 10196487.

Superficial Incisional SSI

Stab wound, pin site infection or stitch abscess alone is not considered an SSI.

a. Time: Occurs within 30 days after any operative procedure (where day 1 = the procedure date)

AND

b. Site: Involves only skin and subcutaneous tissue of the incision

AND

c. Infection: At least one of the following –

  1. Purulent drainage from the superficial incision.
  2. Organism(s) identified from an aseptically-obtained specimen
    from the superficial incision or subcutaneous tissue
  3. Superficial incision with atleast one of localized pain/tenderness, localized swelling, erythema or heat that is deliberately opened by a surgeon/physician/physician designee without culture or non-culture based testing
  4. Diagnosis of a superficial incisional SSI by a physician or physician designee (nursing practitioner or physician assistant; diagnosis/treatment of cellulitis doesn’t meet this criteria)

Deep Incisional SSI

a. Time: Occurs within 30 (for most surgeries) or 90 days (for cardiovascular and orthopedic surgeries) after operative procedure (where day 1 = the procedure date)

AND

b. Site: Involves deep soft tissues of incision (fascia/muscles)

AND

c. Infection: At least one of the following –

  1. Purulent drainage from deep incision
  2. Deep incision that spontaneously dehisces or is deliberately opened by surgeon/physician/physician designee + Isolation of organism based on culture/non-culture testing + Atleast 1 of: fever, localized pain or tenderness
  3. Abscess/Deep infection involving deep incision (gross anatomical/histological/imaging examination)

Organ/Space SSI

a. Time: Occurs within 30 (for most surgeries) or 90 days (for cardiovascular and orthopedic surgeries) after operative procedure (where day 1 = the procedure date)

AND

b. Site: Involves deeper soft tissues (than fascia/muscles) opened/manipulated

AND

c. Infection: At least one of the following –

  1. Purulent drainage from a drain placed into organ/space
  2. Isolation of organism based on culture/non-culture testing from fluid/tissue in organ/space
  3. Abscess/Deep infection involving organ/space (gross anatomical/histological/imaging examination)

Based on CDC definitions: https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf

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