Surgical site infection in gynecology

Abstract

Objective. The morbidity and mortality caused by sur­gi­cal site infections (SSIs) worldwide have become a major pu­blic health issue. Furthermore, the prevention of SSI re­mains a focus for healthcare systems and hospitals due to its healthcare cost reducibility. The objective of this review is to assess the guidelines recommendations re­la­ted to the prevention, diagnosis and management of SSIs. Materials and method. This paper is a review based on information found in literature. The analysis was limited to English language articles and guidelines pu­blished between January 1st, 2015 and April 30th, 2020, on PubMed, using the following keywords: surgical site in­fec­tion, wound infection in gynecology, prophylactic anti­biotics, economic impact of SSIs. In this review we dis­cuss the current trends in the management of SSIs in gy­ne­co­logy. Results. The microorganisms in gynecologic sur­ge­ry are unique as the site of infection may be from the va­gi­nal/genitourinary tract, the abdomen or the skin. The most frequent bacteria in abdominal SSI in gynecologic sur­gery are aerobic Gram-positive cocci (Staphylococcus aureus, Staphylococcus epidermidis). Also, incisions made around the perineum and the groin can become in­fected with Enterococcus species and Escherichia coli. In­ci­sio­nal cellulitis and vaginal cuff cellulitis represent the most com­mon superficial SSI. Deep tissue abscess represents the most common deep infection, whilst tubo-ovarian ab­scesses and pelvic abscesses constitute the most com­mon space and organ infections. The most serious form of SSI is necrotizing fasciitis, a life-threatening com­pli­ca­tion. Conclusions. By rigorously following the clinical re­com­men­dations and evidence, the prevention, diagnosis and treat­ment of SSI can be managed correctly. As a result, health outcomes and healthcare-re­la­ted costs will be greatly improved, thereby the quality of health­care that we deliver to patients will be furthermore increased.