Urban Joshua A
Department of Orthopaedics, Nebraska Orthopaedic Associates, Omaha, Nebraska 68118, USA.
Surg Infect (Larchmt). 2006;7 Suppl 1:S19-22. doi: 10.1089/sur.2006.7.s1-19.
Patients with surgical site infections (SSIs) require a longer time in the hospital, more nursing care, additional dressings, and, possibly, readmission to the hospital and further surgery. The combined direct and indirect costs of treating SSIs may be extremely high.
Review of current practice and guidelines.
The direct costs of SSI include a longer hospital stay, readmission, outpatient and emergency visits, further surgery, and prolonged antibiotic treatment. Other direct costs arise from radiologic procedures, laboratory tests, home health visits and other ancillary services, drugs, and professional fees. Indirect costs, which are difficult to quantify, include lost productivity of the patient and family and a temporary or permanent decline in functional or mental capacity. The cost of SSIs increases with the depth of the infection. That is, the costs associated with superficial incisional SSIs are relatively low, but increase with deep SSI, and especially when organ or space infection is present. The estimated costs of managing SSI differ widely, from less than dollar 400 per case for superficial SSI to more than dollar 30,000 per case for serious organ or space infections.
The need to treat SSIs places a severe financial strain on health care resources. It is possible that treating high-risk surgical patients medically will prove to be more cost-effective than repeated operations.
手术部位感染（SSI）患者需要更长的住院时间、更多的护理、额外的敷料，并且可能需要再次入院和进一步手术。治疗SSI的直接和间接成本可能极高。
回顾当前的实践和指南。
SSI的直接成本包括更长的住院时间、再次入院、门诊和急诊就诊、进一步手术以及延长的抗生素治疗。其他直接成本来自放射学检查、实验室检查、家庭健康访视和其他辅助服务、药物以及专业费用。间接成本难以量化，包括患者和家属的生产力损失以及功能或心理能力的暂时或永久下降。SSI的成本随着感染深度的增加而增加。也就是说，与浅表切口SSI相关的成本相对较低，但随着深部SSI的增加而增加，尤其是存在器官或腔隙感染时。管理SSI的估计成本差异很大，浅表SSI每例不到400美元，严重器官或腔隙感染每例超过30000美元。
治疗SSI的需求给医疗资源带来了严重的经济压力。对高危手术患者进行药物治疗可能比重复手术更具成本效益。
