Table 1 Definition and classification of surgical site infection (SSI) [19]

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 one 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 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.

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

Notes:

Do not report the following conditions as SSI:

• Stitch abscess (minimal inflammation and discharge confined to the points of suture penetration).

Deep incisional SSI

Infection occurs within 30 days after the operation and the infection appears to be related to the operation and infection involves deep soft tissues (e.g. fascial and muscle layers) of the incision and at least one 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 and the infection appears to be related to the operation and 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 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.