Key Points
����Organ/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 30or 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
Operative Site/Procedure
30-day Surveillance
Abdominal aortic aneurysm Heart transplant
Rectum
Abdominal hysterectomy
Kidney
Shunt for dialysis
Appendix
Kidney transplant
Small bowel
Bile duct, liver or pancreas Laminectomy
Spleen
Carotid endarterectomy
Limb amputation
Stomach
Colon
Liver transplant
Thorax
Cesarean section
Neck
Thyroid and/or parathyroid
Exploratory Laparotomy
Ovary
Vaginal hysterectomy
Gallbladder
Prostate
Other operative procedures not included in the NHSN categories
90-day Surveillance
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
(Procedure Associated Module: Surgical Site Infection Event. Guidelines and procedures for
2 monitoring SSI. January 2013. CDC)
a
