Table 1 Definitions of abdominal surgical site infections classified according to the Centres for Disease Control and Prevention [9]
Superficial incisional surgical site infections | Deep incisional surgical site infectionsa | Organ or space surgical site infections |
|---|---|---|
1. Infection occurs within 30 days after the operation, and | 1. Infection occurs within 30 days after the operation, and | 1. Infection occurs within 30 after the operation, and |
2. Infection involves only skin or subcutaneous tissue of the incision, and | 2. Infection involves deep soft tissues (e.g., fascial and muscle layers) of the incision, and | 2. Infection involves any part of the anatomy (e.g., organs or spaces), other than the incision, which was opened or manipulated during an operation, and |
3. At least one of items A to D | 3. At least one of items A to D | 3. At least one of items A to D |
A. Purulent drainage, with or without laboratory confirmation, from the superficial incision | A. Purulent drainage from the deep incision but not from the organ or space component of the surgical site | A. Purulent drainage from a drain that is placed through a stab woundb into the organ or space |
B. Organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision | B. 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 | B. Organisms isolated from an aseptically obtained culture of fluid or tissue in the organ or space |
C. At least one 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 | C. An abscess or other evidence of infection involving the deep incision is found on direct examination, during reoperation, or by histopathologic or radiological examination | C. An abscess or other evidence of infection involving the organ or space that is found on direct examination, during reoperation, or by histopathologic or radiological examination |
D. Diagnosis of superficial incisional surgical site infections by the surgeon or attending physician | D. Diagnosis of a deep incisional surgical site infection by a surgeon or attending physician | D. Diagnosis of an organ or space surgical site infection by a surgeon or attending physician |