Surgical Site Infection Definitions: why are they important?

Surgical site infections (SSIs) are the burden of our surgical practice. They account for as many as one-fourth of all nosocomial infections and are the most common cause of infections in human surgical patients[1]. They lead to increased health care cost due to additional treatment, antimicrobial administrations, extended hospital stay and patient morbidity/mortality. Further, in veterinary patients these complications create emotional and financial distress for owners and drastically affect the animal’s welfare. Fortunately we are distant from the early days of surgery, were the treatment was worse than the actual pathology. In those days, most surgical procedures would fail due to infectious complications. In the early 18th century, pus was thought to be normal, even adequate during the phases of wound healing. Discoveries made by Louis Pasteur revealed the involvement of microbes in this process and simultaneously methods were established to focus on combating the sepsis. Anti-sepsis was born.

Prior to the antimicrobial era, the pioneering work of Semmelweis in the mid 1800’s made us understand the critical role of the hands of healthcare workers in the transmission of infections[2]. Soon after and lead by Pasteur’s saying: “Instead of fighting bacteria in wounds, would it not just be better not to introduce them” surgeons like Koch, Lister and Halstead developed the principles to avoid the development of sepsis: the principles of asepsis and aseptic technique were established. These discoveries coupled with the understanding of the germ theory of disease and the development of aseptic techniques may have had the greatest impact on patient survival with regard to infectious diseases or any other medical advancement. With the dawn of antimicrobials, many thought that infectious diseases would become a thing of the past, and the focus on prevention measures may have lapsed due to the ease with which infections could seemingly be treated. However, in the late 20th and early 21st century, with the effectiveness of the antimicrobial arsenal waning, infection prevention has come to the forefront once again. Considering no pathogen has yet developed any resistance to aseptic technique, the above saying by Pasteur is therefore more pertinent than ever in our journey trying to chase zero infection rates. [...]