Surgical Site Infections

Surgical site infections (SSIs) have played a major role in the evolution of medical care throughout history. Wound complications contributed significantly to the historical surgical mortality rates before the development of Lister’s aseptic approach in the nineteenth century. The impact of the antiseptic/aseptic techniques was readily apparent in its adaptation to battlefield medicine. During the Civil War in America, surgeons routinely operated bare-handed, with wound suppuration considered to be a beneficial aspect of wound healing. With the gradual acceptance of the principles of antisepsis, and the usage of sterile dressings and aseptic surgical technique, there was a dramatic reduction in mortality from wounds to 7.4% in the Spanish-American War. Despite nearly 2 centuries of medical progress, the management of surgical infection remains a pressing concern, and SSIs continue to be a leading component of nosocomial morbidity and mortality. In this article, the epidemiology, pathogenesis,