A surgical site is the incision in the skin made by a surgeon to carry out a surgical procedure. High standards of asepsis in operating theatres mean these procedures are generally safe. However, bacteria from the skin, other parts of the body or the environment can sometimes enter through the incision and multiply in the tissues, leading to what is known as a surgical site infection (SSI). The risk of developing an SSI varies depending on a number of factors including the general health of the patient, the type and duration of surgery and the environment. They are not always preventable.
There are three types of SSI: superficial, deep and organ space. Superficial infections only involve the skin. They may cause some short-term pain and discomfort for the patient and lead to discharge from the wound, but they are easily treated, usually with a course of antibiotics. Deep and organ space infections have generally spread further, have more severe signs and symptoms (such as abscesses), and are more likely to require further surgery or prolonged treatment in some cases. SSIs can therefore be a burden to the patient and an added cost to the NHS.
Public Health Wales facilitate surveillance of SSIs post-surgery to determine infection rates associated with various surgical procedures. Schemes including Caesarean section procedures (mandated by the Welsh Government for all hospitals since 2006), orthopaedic procedures, including hip and knee replacements (mandated since 2003) and general surgical procedures (primarily colorectal) piloted in 2018.