Section of Surgical Critical Care, Baylor College of Medicine, and Department of Surgery and Surgical Intensive Care Unit, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas 77030, USA.
Surg Infect (Larchmt). 2012 Aug;13(4):234-7. doi: 10.1089/sur.2012.131. Epub 2012 Aug 22.
Surgical site infection (SSI) is unequivocally morbid and costly. The estimated 300,000 SSIs annually in the United States represent the second most common infection among surgical patients, prolong hospitalization by 7-10 days, and have an estimated annual incremental cost of $1 billion. The mortality rate associated with SSI is 3%, with about three quarters of deaths being attributable directly to the infection. Prevention is possible for the most part, and concerted effort has been made to limit these infections, arguably to little effect.
Review of pertinent English-language literature.
Numerous risk factors for SSI and tactics for prevention have been described, but efforts to bundle these tactics into an effective, comprehensive prevention program have been disappointing. Numerous studies now demonstrate that the Surgical Care Improvement Program (SCIP), which focused on process improvement rather than outcomes, has been ineffective despite governmental support, financial penalties for non-compliance, and consequent widespread implementation.
Required reporting has increased awareness of the problem of SSI, but just as the complexity of SSI risk, pathogenesis, and preventions reflects the complexity of the disease, many other factors must be taken into account, including the skill and knowledge of the surgical team and promulgation of a culture of quality and safety in surgical patient care.
手术部位感染（SSI）无疑是病态且昂贵的。据估计，美国每年有 30 万例 SSI，是外科患者中第二常见的感染，使住院时间延长 7-10 天，估计每年的增量成本为 10 亿美元。SSI 相关的死亡率为 3%，其中约四分之三的死亡直接归因于感染。大部分情况下，SSI 是可以预防的，人们已经做出了协同努力来限制这些感染，但收效甚微。
回顾相关的英文文献。
已经描述了许多 SSI 的风险因素和预防策略，但将这些策略整合到一个有效、全面的预防计划中的努力令人失望。许多研究表明，外科护理改进计划（SCIP）虽然得到了政府的支持、对不合规行为的经济处罚以及随后的广泛实施，但由于专注于流程改进而不是结果，该计划一直没有效果。
强制性报告提高了对 SSI 问题的认识，但正如 SSI 的风险、发病机制和预防措施的复杂性反映了疾病的复杂性一样，还必须考虑许多其他因素，包括外科团队的技能和知识，以及在外科患者护理中宣传质量和安全文化。
