Key Points
ÎÎOrgan/space SSI: involves any part of the body—excluding the skin
incision, fascia, or muscle layers—that is opened or manipulated
during the operative procedure. Specific sites are assigned to
organ/space SSI to further identify the location of the infection
(eg, endocarditis, endometritis, mediastinitis, vaginal cuff, and
osteomyelitis). Organ/space SSI must meet the following criteria:
a
• Infection occurs within 30 or 90 daysa after the operative procedure if no implant
is in place or within 1 year if implant is in place and the infection appears to be
related to the operative procedure,
• 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
• The patient has at least one of the following:
▶▶ Purulent drainage from a drain that is placed through a stab wound into the
organ/space.
▶▶ Organisms isolated from an aseptically obtained culture of fluid or tissue in the
organ/space.
▶▶ 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.
▶▶ Diagnosis of an organ/space SSI by a surgeon or attending physician.
See Table 1
Table 1. Surveillance Period for Deep Incisional or
Organ/Space SSI Following Selected NHSN
Operative Procedure Categoriesa
90-day Surveillance
30-day Surveillance
Operative Site/Procedure
a
2
Abdominal aortic aneurysm
Abdominal hysterectomy
Appendix
Bile duct, liver or pancreas
Carotid endarterectomy
Colon
Cesarean section
Heart transplant
Kidney
Kidney transplant
Laminectomy
Limb amputation
Liver transplant
Neck
Rectum
Shunt for dialysis
Small bowel
Spleen
Stomach
Thorax
Thyroid and/or
parathyroid
Vaginal hysterectomy
Exploratory Laparotomy
Ovary
Gallbladder
Prostate
Other operative procedures not included in the NHSN categories
Breast
Hip prosthesis
Peripheral vascular bypass
Craniotomy
Knee prosthesis
Refusion of spine
Heart
Open reduction of fracture Spinal fusion
Herniorrhaphy
Pacemaker
Ventricular shunt
Coronary artery bypass graft with both chest and donor site incisions
Coronary artery bypass graft with chest incision only
Modified from the published guidelines to include recently updated definitions from the NHSN
Centers for Disease Control and Prevention. Procedure-Associated Module: Surgical Site Infection
Event. National Healthcare Safety Network Patient Safety Component. 2013 Jan. http://www.cdc.
gov/nhsn/psc_pa.html (accessed 2013 Feb 14).