CHASING ZERO: THE DRIVE TO ELIMINATE SURGICAL SITE INFECTIONS
SSIs remain a substantial cause of morbidity, prolonged hospitalization, and death. SSI are the second most common hospital acquired infections in United States and the European Union and occur in approximately 2% to 5% of patients undergoing inpatient surgery worldwide 1. The incidence of SSI is doubled in high risk patients and in surgeries such as colorectal, SSIs can reach 30%. The outcome of Deep Sternal SSI can carry a mortality rate of up to 40%.
SSIs might result in 1,2
- $10 billion of incremental hospital costs per year in US and ~7 billion per year in European union.
- Increased length of post operative hospital stay by 7-10 days.
- Directly attributable costs of SSIs range from $11,000 to $26,000 per infection.
- In more complex infections involving a prosthetic joint or antimicrobial-resistant organism, the cost per case can exceed $90,000.
- 2 - 11 times increased risk of death compared to infection free patients.
Systemic antibacterial solutions are not sufficiently effective due to low target penetration.
The insufficient penetration can be:
- Temporary due to surgery related trauma to the tissue.
- Constant due to the nature of the target area.
(1) Anderson, D.J. et al, Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update, Infect Control Hosp Epidemiol 2014;35(6):605-627
(2) Kirkland KB, et al. Clin Infect Dis. 2003
PERIOPERATIVE SYSTEMIC ANTIBIOTICS (IV, ORAL) PROPHYLAXIS IS NOT
- Systemic antibiotics (IV or oral) used during the course of surgery, typically beginning an hour before surgery, are not effective to prevent all SSIs
- The antibiotic penetration to the surgical wound during and post operation is significantly limited because of the surgical incision and the damage to blood vessels 1,2*
- Systemic antibiotics may be limited in their ability to reach the target site due to surgical disruption of local blood supply.