Surgical site infection, definitions and classification
A surgical wound with local signs and symptoms of infection:
- Heat, redness, pain and swelling,
- (in more serious cases) with systemic signs of fever or a raised white blood cell count.
The treatment recommendations for a surgical site infection are dependent on the type and location of the wound and severity of infection:
Wound type:
Clean: an incision in which no inflammation is encountered in a surgical procedure, without a break in sterile technique, and during which the respiratory, alimentary or genitourinary tracts are not entered.
See: Surgical site infection, clean procedures
Clean-contaminated: an incision through which the respiratory, alimentary, or genitourinary tract is entered under controlled conditions but with no contamination encountered.
See Surgical site infection, clean-contaminated, contaminated and infected procedures
Contaminated: an incision undertaken during an operation in which there is a major break in sterile technique or gross spillage from the gastrointestinal tract, or an incision in which acute, non-purulent inflammation is encountered. Open traumatic wounds that are more than 12 to 24 hours old also fall into this category.
See Surgical site infection, clean-contaminated, contaminated and infected procedures
Infected: an incision undertaken during an operation in which the viscera are perforated or when acute inflammation with pus is encountered (for example, emergency surgery for faecal peritonitis), and for traumatic wounds if treatment is delayed, there is faecal contamination, or devitalised tissue is present
See Surgical site infection, clean-contaminated, contaminated and infected procedures
Reference
NICE NG 125 Surgical site infections: prevention and treatment August 2020. Available: NICE guideline 125: Surgical site infections: prevention and treatment