Surgical Site Infection: The Clinical and Economic Impact

Megan C Turner, John Migaly, Megan C Turner, John Migaly

Abstract

Surgical site infection (SSI) following colorectal surgery is associated with worse postoperative outcomes, longer length of stay, and higher rates of readmission. SSI rates have been established as a surrogate metric for the overall quality of surgical care and are intricately tied to financial incentives and the public reputation of an institution. While risk factors and prevention mechanisms for SSI are well established, the rates of SSI remain high. This article discusses the clinical and economic impact of SSI and strategies for mitigating the risk of SSI through bundled prevention practices.

Keywords: complications; cost; economic impact of SSI; surgical site infection; surgical site infection prevention bundles.

Conflict of interest statement

Conflict of Interest The authors have no disclosure and received no financial support for their contributions to this article.

Figures

Fig. 1
Fig. 1
Impact of surgical site infection (SSI) on length of stay, showing increased length of stay in patients with SSI (de Lissovoy et al in 2009).
Fig. 2
Fig. 2
Impact of surgical site infection (SSI) on cost, showing increased cost for patients experiencing SSI across specialties (de Lissovoy et al in 2009).
Fig. 3
Fig. 3
Reimbursement penalties from Center Medicare/Medicaid Services. HAC, hospital-acquired condition; RRP, readmission reduction program; VBP: value-based payment.
Fig. 4
Fig. 4
Surgical site infection prevention bundle described by Bull et al (2011).
Fig. 5
Fig. 5
Surgical site infection prevention bundle described by Keenan et al (2014).
Fig. 6
Fig. 6
Impact surgical site infection prevention bundle by Michigan Collaborative described by Vu et al (2017).
Fig. 7
Fig. 7
Postoperative complication rates and surgical site infection rates by surgical site infection (SSI) prevention bundle compliance score (Vu et al, 2017).
Fig. 8
Fig. 8
Mean costs per admission US Dollar (USD 2013) following implementation of enhanced recovery pathway (ERP) in 2010 and surgical site infection prevention bundle 2011 by Keenan et al (2015).

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