Table 1.

Surgical Site Infections

Superficial incisional SSI

Infection occurs within 30 days after the operation and infection involves only skin or subcutaneous tissue of the incision and at least 1 of the following:

Purulent drainage, with or without laboratory confirmation, from the superficial incision.

Organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision.

At least 1 of the following signs or symptoms of infection: pain or tenderness, localized swelling, redness, or heat, and superficial incision is deliberately opened by surgeon unless incision is culture-negative.

Diagnosis of superficial incisional SSI by the surgeon or attending physician.

Deep incisional SSI

Infection occurs within 30 days after the operation if no implant is left in place or within 1 year if implant is in place and the infection appears to be related to the operation and infection involves deep soft tissues (eg fascial and muscle layers) of the incision and at least 1 of the following:

Purulent drainage from the deep incision but not from the organ/space component of the surgical site.

A deep incision spontaneously dehisces or is deliberately opened by a surgeon when the patient has at least one of the following signs or symptoms: fever (>38°C), localized pain, or tenderness, unless site is culture-negative.

An abscess or other evidence of infection involving the deep incision is found on direct examination, during reoperation, or by histopathologic or radiologic examination.

Diagnosis of a deep incisional SSI by a surgeon or attending physician.

Notes

Report infection that involves both superficial and deep incision sites as deep incisional SSI.

Report an organ/space SSI that drains through the incision as a deep incisional SSI.

Organ/space SSI

Infection occurs within 30 days after the operation if no implant is left in place or within 1 year if implant is in place and the infection appears to be related to the operation and infection involves any part of the anatomy (eg organs or spaces), other than the incision, which was opened or manipulated during an operation and at least 1 of the following:

Purulent drainage from a drain that is placed through a stab wound. If the area around a stab wound becomes infected, it is not an SSI. It is considered a skin or soft-tissue infection, depending on its depth 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.

SSI, surgical site infection.