Trends in surgical site infection in Scotland 2002 to 2007

Background: Surgical site infection (SSI) is one of the most common healthcare associated infections (HAI) accounting for around 16% of all HAI and is estimated to cost the National Heath Service (NHS) in Scotland €240 million per year.  SSI adds 5.7 days to a patient’s inpatient stay and cost €2600 per patient. SSI is an important outcome measure for surgical procedures. SSI data have been collected for all Scotland for 5 years and Health Protection Scotland facilitate the national surveillance of SSI.

Objective: To assess the impact of 5 years of surgical site infection surveillance on SSI rates from 1/4/2002 to 30/6/2007.

Methods: Surveillance in Scotland is conducted according to a standard national protocol, with adherence to the CDC definitions for SSI, which are internationally comparable, within that protocol.

Results: For 2002 to 2007, 1270 inpatient SSIs, resulting from 81198 operations have been reported. In the last year 261 inpatient SSIs resulting from 24136 operations have been reported to SSHAIP.
Inpatient SSI rates for six categories of surgery ranged from 0.6% (0.5%, 0.8%) for knee arthroplasty to 2.4% (2.1%, 2.8%) for open reduction of long bone fracture.

Conclusions: SSI rates for the last year are lower than the previous year for all categories of surgery, indicating a downward trend in SSI in Scotland. There is a significant reduction in inpatient SSI rates for hips, knees and caesarean sections for the last year of surveillance