scholarly journals Administrative Coding Methods Impact Surgical Site Infection Rates

2020 ◽  
Vol 41 (S1) ◽  
pp. s111-s112
Author(s):  
Mohammed Alsuhaibani ◽  
Mohammed Alzunitan ◽  
Kyle Jenn ◽  
Daniel Diekema ◽  
Michael Edmond ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Surgical Procedures ◽  
Hip Prosthesis ◽  
Knee Prosthesis ◽  
Surgical Site Infections ◽  
Fold Increase ◽  
Abdominal Hysterectomy ◽  
Absolute Difference ◽  
Coding Method ◽  
The Impact

Background: Surveillance for surgical site infections (SSI) is recommended by the CDC. Currently, colon and abdominal hysterectomy SSI rates are publicly available and impact hospital reimbursement. However, the CDC NHSN allows surgical procedures to be abstracted based on International Classification of Diseases, Tenth Revision (ICD-10) or current procedural terminology (CPT) codes. We assessed the impact of using ICD and/or CPT codes on the number of cases abstracted and SSI rates. Methods: We retrieved administrative codes (ICD and/or CPT) for procedures performed at the University of Iowa Hospitals & Clinics over 1 year: October 2018–September 2019. We included 10 procedure types: colon, hysterectomy, cesarean section, breast, cardiac, craniotomy, spinal fusion, laminectomy, hip prosthesis, and knee prosthesis surgeries. We then calculated the number of procedures that would be abstracted if we used different permutations in administration codes: (1) ICD codes only, (2) CPT codes only, (3) both ICD and CPT codes, and (4) at least 1 code from either ICD or CPT. We then calculated the impact on SSI rates based on any of the 4 coding permutations. Results: In total, 9,583 surgical procedures and 180 SSIs were detected during the study period using the fourth method (ICD or CPT codes). Denominators varied according to procedure type and coding method used. The number of procedures abstracted for breast surgery had a >10-fold difference if reported based on ICD only versus ICD or CPT codes (104 vs 1,109). Hip prosthesis had the lowest variation (638 vs 767). For SSI rates, cesarean section showed almost a 3-fold increment (2.6% when using ICD only to 7.32% with both ICD & CPT), whereas abdominal hysterectomy showed nearly a 2-fold increase (1.14% when using CPT only to 2.22% with both ICD & CPT codes). However, SSI rates remained fairly similar for craniotomy (0.14% absolute difference), hip prosthesis (0.24% absolute difference), and colon (0.09% absolute difference) despite differences in the number of abstracted procedures and coding methods. Conclusions: Denominators and SSI rates vary depending on the coding method used. Variations in the number of procedures abstracted and their subsequent impact on SSI rates were not predictable. Variations in coding methods used by hospitals could impact interhospital comparisons and benchmarking, potentially leading to disparities in public reporting and hospital penalties.Funding: NoneDisclosures: None

scholarly journals Impact of Postdischarge Surveillance on Surgical Site Infection Rates for Several Surgical Procedures Results From the Nosocomial Surveillance Network in The Netherlands

2006 ◽  
Vol 27 (08) ◽  
pp. 809-816 ◽  
Author(s):  
Judith Manniën ◽  
Jan C. Wille ◽  
Ruud L. M. M. Snoeren ◽  
Susan van den Hof
Keyword(s):  
Medical Record ◽  
Surgical Procedures ◽  
Clinical Symptoms ◽  
Knee Prosthesis ◽  
Surgical Site Infections ◽  
Abdominal Hysterectomy ◽  
Surveillance Network ◽  
Femorotibial Bypass ◽  
Registration Card

Objective. To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important. Design. Prospective SSI surveillance with voluntary PDS. Recommended methods for PDS in the Dutch national nosocomial surveillance network are addition of a special registration card to the outpatient medical record, on which the surgeon notes clinical symptoms and whether a patient developed an SSI according to the definitions; an alternative method is examination of the outpatient medical record. Setting. Hospitals participating in the Dutch national nosocomial surveillance network between 1996 and 2004. Results. We collected data on 131,798 surgical procedures performed in 64 of the 98 Dutch hospitals. PDS was performed according to one of the recommended methods for 31,134 operations (24%) and according to another active method for 32,589 operations (25%), and passive PDS was performed for 68,075 operations (52%). Relatively more SSIs were recorded after discharge for cases in which PDS was performed according to a recommended method (43%), compared with cases in which another active PDS method was used (30%) and cases in which passive PDS was used (25%). The highest rate of SSI after discharge was found for appendectomy (79% of operations), followed by knee prosthesis surgery (64%), mastectomy (61%), femoropopliteal or femorotibial bypass (53%), and abdominal hysterectomy (53%). Conclusions. For certain surgical procedures, most SSIs develop after discharge. SSI rates will be underestimated if no PDS is performed. We believe we have found a feasible and sensitive method for PDS that, if patients routinely return to the hospital for a postdischarge follow-up visit, might be suitable for use internationally.

scholarly journals Impact of Postdischarge Surveillance on Surgical Site Infection Rates for Several Surgical Procedures Results From the Nosocomial Surveillance Network in The Netherlands

2006 ◽  
Vol 27 (8) ◽  
pp. 809-816 ◽  
Author(s):  
Judith Manniën ◽  
Jan C. Wille ◽  
Ruud L. M. M. Snoeren ◽  
Susan van den Hof
Keyword(s):  
Medical Record ◽  
Surgical Procedures ◽  
Clinical Symptoms ◽  
Knee Prosthesis ◽  
Surgical Site Infections ◽  
Abdominal Hysterectomy ◽  
Surveillance Network ◽  
Femorotibial Bypass ◽  
Registration Card

Objective.To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important.Design.Prospective SSI surveillance with voluntary PDS. Recommended methods for PDS in the Dutch national nosocomial surveillance network are addition of a special registration card to the outpatient medical record, on which the surgeon notes clinical symptoms and whether a patient developed an SSI according to the definitions; an alternative method is examination of the outpatient medical record.Setting.Hospitals participating in the Dutch national nosocomial surveillance network between 1996 and 2004.Results.We collected data on 131,798 surgical procedures performed in 64 of the 98 Dutch hospitals. PDS was performed according to one of the recommended methods for 31,134 operations (24%) and according to another active method for 32,589 operations (25%), and passive PDS was performed for 68,075 operations (52%). Relatively more SSIs were recorded after discharge for cases in which PDS was performed according to a recommended method (43%), compared with cases in which another active PDS method was used (30%) and cases in which passive PDS was used (25%). The highest rate of SSI after discharge was found for appendectomy (79% of operations), followed by knee prosthesis surgery (64%), mastectomy (61%), femoropopliteal or femorotibial bypass (53%), and abdominal hysterectomy (53%).Conclusions.For certain surgical procedures, most SSIs develop after discharge. SSI rates will be underestimated if no PDS is performed. We believe we have found a feasible and sensitive method for PDS that, if patients routinely return to the hospital for a postdischarge follow-up visit, might be suitable for use internationally.

Complex Surgical Site Infections and the Devilish Details of Risk Adjustment: Important Implications for Public Reporting

2008 ◽  
Vol 29 (10) ◽  
pp. 941-946 ◽  
Author(s):  
Deverick J. Anderson ◽  
Luke F. Chen ◽  
Daniel J. Sexton ◽  
Keith S. Kaye
Keyword(s):  
Hip Prosthesis ◽  
Knee Prosthesis ◽  
Risk Index ◽  
Surgical Site Infections ◽  
Abdominal Hysterectomy ◽  
Index Score ◽  
Case Mix ◽  
Infection Surveillance ◽  
Reporting Rates ◽  
Risk Index Score

Objective.To validate the National Nosocomial Infection Surveillance (NNIS) risk index as a tool to account for differences in case mix when reporting rates of complex surgical site infection (SSI).Design.Prospective cohort study.Setting.Twenty-four community hospitals in the southeastern United States.Methods.We identified surgical procedures performed between January 1, 2005, and June 30, 2007. The Goodman-Kruskal gamma or G statistic was used to determine the correlation between the NNIS risk index score and the rates of complex SSI (not including superficial incisional SSI). Procedure-specific analyses were performed for SSI after abdominal hysterectomy, cardiothoracic procedures, colon procedures, insertion of a hip prosthesis, insertion of a knee prosthesis, and vascular procedures.Results.A total of 2,257 SSIs were identified during the study period (overall rate, 1.19 SSIs per 100 procedures), of which 1,093 (48.4%) were complex (0.58 complex SSIs per 100 procedures). There were 45 complex SSIs identified following 7,032 abdominal hysterectomies (rate, 0.64 SSIs per 100 procedures); 63 following 5,318 cardiothoracic procedures (1.18 SSIs per 100 procedures); 139 following 5,144 colon procedures (2.70 SSIs per 100 procedures); 63 following 6,639 hip prosthesis insertions (0.94 SSIs per 100 procedures); 73 following 9,658 knee prosthesis insertions (0.76 SSIs per 100 procedures); and 55 following 6,575 vascular procedures (0.84 SSIs per 100 procedures). All 6 procedure-specific rates of complex SSI were significantly correlated with increasing NNIS risk index score (P< .05).Conclusions.Some experts recommend reporting rates of complex SSI to overcome the widely acknowledged detection bias associated with superficial incisional infection. Furthermore, it is necessary to compensate for case-mix differences in patient populations, to ensure that intrahospital comparisons are meaningful. Our results indicate that the NNIS risk index is a reasonable method for the risk stratification of complex SSIs for several commonly performed procedures.

Surgical Site Infections, International Nosocomial Infection Control Consortium (INICC) Report, Data Summary of 30 Countries, 2005–2010

2013 ◽  
Vol 34 (6) ◽  
pp. 597-604 ◽  
Author(s):  
Victor D. Rosenthal ◽  
Rosana Richtmann ◽  
Sanjeev Singh ◽  
Anucha Apisarnthanarak ◽  
Andrzej Kübler ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Hip Prosthesis ◽  
Coronary Bypass ◽  
Surgical Site Infections ◽  
Abdominal Hysterectomy ◽  
International Classification Of Diseases ◽  
Surveillance Study ◽  
Classification Of Diseases ◽  
Control And Prevention

Objective.To report the results of a surveillance study on surgical site infections (SSIs) conducted by the International Nosocomial Infection Control Consortium (INICC).Design.Cohort prospective multinational multicenter surveillance study.Setting.Eighty-two hospitals of 66 cities in 30 countries (Argentina, Brazil, Colombia, Cuba, Dominican Republic, Egypt, Greece, India, Kosovo, Lebanon, Lithuania, Macedonia, Malaysia, Mexico, Morocco, Pakistan, Panama, Peru, Philippines, Poland, Salvador, Saudi Arabia, Serbia, Singapore, Slovakia, Sudan, Thailand, Turkey, Uruguay, and Vietnam) from 4 continents (America, Asia, Africa, and Europe).Patients.Patients undergoing surgical procedures (SPs) from January 2005 to December 2010.Methods.Data were gathered and recorded from patients hospitalized in INICC member hospitals by using the methods and definitions of the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) for SSI. SPs were classified into 31 types according toInternational Classification of Diseases, Ninth Revision, criteria.Results.We gathered data from 7,523 SSIs associated with 260,973 SPs. SSI rates were significantly higher for most SPs in INICC hospitals compared with CDC-NHSN data, including the rates of SSI after hip prosthesis (2.6% vs 1.3%; relative risk [RR], 2.06 [95% confidence interval (CI), 1.8–2.4];P<.001), coronary bypass with chest and donor incision (4.5% vs 2.9%; RR, 1.52 [95% CI, 1.4–1.6];P<.001); abdominal hysterectomy (2.7% vs 1.6%; RR, 1.66 [95% CI, 1.4–2.0];P<.001); exploratory abdominal surgery (4.1 % vs 2.0%; RR, 2.05 [95% CI, 1.6–2.6];P<.001); ventricular shunt, 12.9% vs 5.6% (RR, 2.3 [95% CI, 1.9–2.6];P<.001), and others.Conclusions.SSI rates were higher for most SPs in INICC hospitals compared with CDC-NHSN data.

scholarly journals Healthcare resources attributable to methicillin-resistant Staphylococcus aureus orthopedic surgical site infections

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Haruhisa Fukuda ◽  
Daisuke Sato ◽  
Tetsuya Iwamoto ◽  
Koji Yamada ◽  
Kazuhiko Matsushita
Keyword(s):  
Staphylococcus Aureus ◽  
Hip Prosthesis ◽  
Knee Prosthesis ◽  
Surgical Site Infections ◽  
Healthcare Resource Utilization ◽  
Prevention Measures ◽  
Healthcare Resources ◽  
Methicillin Resistant ◽  
Japanese Residents ◽  
Almost All

Abstract The number of orthopedic surgeries is increasing as populations steadily age, but surgical site infection (SSI) rates remain relatively consistent. This study aimed to quantify the healthcare resources attributable to methicillin-resistant Staphylococcus aureus (MRSA) SSIs in orthopedic surgical patients. The analysis was conducted using a national claims database comprising data from almost all Japanese residents. We examined patients who underwent any of the following surgeries between April 2012 and March 2018: amputation (AMP), spinal fusion (FUSN), open reduction of fracture (FX), hip prosthesis (HPRO), knee prosthesis (KPRO), and laminectomy (LAM). Propensity score matching was performed to identify non-SSI control patients, and generalized estimating equations were used to estimate the differences in outcomes between the case and control groups. The numbers of MRSA SSI cases (infection rates) ranged from 64 (0.03%) to 1,152 (2.33%). MRSA SSI-attributable increases in healthcare expenditure ranged from $11,630 ($21,151 vs. $9,521) for LAM to $35,693 ($50,122 vs. $14,429) for FX, and increases in hospital stay ranged from 40.6 days (59.2 vs. 18.6) for LAM to 89.5 days (122.0 vs. 32.5) for FX. In conclusion, MRSA SSIs contribute to substantial increases in healthcare resource utilization, emphasizing the need to implement effective infection prevention measures for orthopedic surgeries.

scholarly journals 567. Does Universal Nasal Decolonization with an Alcohol-Based Nasal Antiseptic Reduce Infection Risk and Cost?

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S268-S268
Author(s):  
Scott Arden
Keyword(s):  
Surgical Procedures ◽  
Surgical Site Infections ◽  
Infection Risk ◽  
Practice Change ◽  
Screening Tests ◽  
Contact Precautions ◽  
Chlorhexidine Bathing ◽  
Before And After ◽  
The Cost ◽  
The Impact

Abstract Background Nasal decolonization with mupirocin to reduce infection risk, has been associated with mupirocin-resistant Staphylococcus aureus (SA). A community hospital identified two patients colonized with methicillin and mupirocin-resistant SA (MRSA), one scheduled for surgery, one for inpatient IV antibiotic therapy. Instead of mupirocin, an alcohol based nasal antiseptic was applied to these patients twice daily for 5 days, resulting in a negative MRSA nasal screening test in both patients. Neither patient developed an infection during or after treatment. Building on this success, a plan was made to assess the impact of universal nasal decolonization to replace screening and contact precautions for MRSA colonized patients, and to reduce surgical site infections (SSI). Methods A 12-month project using a before and after design, was initiated in April 2018. The project involved twice daily application of alcohol-based nasal antiseptic for all inpatients, and preoperatively for all surgical patients in addition to existing preoperative chlorhexidine bathing. No other practice change was made during this period. Assessment of impact was planned by comparing the incidence of MRSA bacteremia and SSI at baseline (2017) and after project implementation, in addition to costs avoided with reduction of nasal screening and CP. Results Compared with baseline, between April 2018 and March 2019, there was a decrease in MRSA bacteremia from 3/1,000 patient-days to 0/1,000 patient-days, a reduction in CP from 3.78 to 1.53/1,000 patient-days, a reduction in nasal screens from 3,874 to 605, and a reduction of all-cause (Gram-negative and Gram-positive) SSI after all surgical procedures from 3/4,313 procedures to 0/4,872 procedures. After accounting for the cost of the nasal antiseptic, the reduction in gowns, gloves and nasal screening tests resulted in $104,099.91costs avoided. Conclusion House-wide application of alcohol-based nasal antiseptic in place of screening and contact precautions, resulted in a reduced incidence of both MRSA bacteremia and SSI for all types of surgical procedures, in addition to significant costs avoided. Disclosures All authors: No reported disclosures.

scholarly journals The Impact of Depth of Infection and Postdischarge Surveillance on Rate of Surgical-Site Infections in a Network of Community Hospitals

2012 ◽  
Vol 33 (3) ◽  
pp. 276-282 ◽  
Author(s):  
David Y. Ming ◽  
Luke F. Chen ◽  
Becky A. Miller ◽  
Daniel J. Sexton ◽  
Deverick J. Anderson
Keyword(s):  
Surgical Procedures ◽  
Surgical Site Infections ◽  
Inpatient Setting ◽  
Community Hospitals ◽  
Comparative Performance ◽  
Median Proportion ◽  
Inpatient Settings ◽  
The Impact ◽  
Reporting Method ◽  
Performance Ranking

Objective.To describe the epidemiology of surgical-site infections (SSIs) in community hospitals and to explore the impact of depth of SSI, healthcare location at the time of diagnosis, and variations in surveillance practices on the overall rate of SSI.Design.Retrospective cohort study.Setting.Thirty-seven community hospitals in the southeastern United States.Patients.Consecutive sample of patients undergoing surgical procedures between July 1, 2007, and December 31, 2008.Methods.ANOVA was used to compare rates of SSIs, and the F test was used to compare the distribution of rates of SSIs. Wilcoxon rank-sum was used to test for differences in performance rankings of hospitals.Results.Following 177,706 surgical procedures, 1,919 SSIs were identified (incidence, 1.08 per 100 procedures). Sixty-four percent (1,223 of 1,919) of these were identified as complex SSIs; 87% of the complex SSIs were diagnosed in inpatient settings. The median proportion of superficial-incisional SSIs was 37% (interquartile range, 29.6%–49.5%). Postdischarge SSI surveillance was variable, with 58% of responding hospitals using surgeon letters. As reporting focus was narrowed from all SSIs to complex SSIs (incidence, 0.69 per 100 procedures) and, finally, to complex SSIs diagnosed in the inpatient setting (incidence, 0.51 per 100 procedures), variance in rates changed significantly (P = .02). Performance ranking of individual hospitals, based on rates of SSIs, differed significandy, depending on the reporting method utilized (P = .0006).Conclusions.Inconsistent reporting mediods focused on variable depths of infection and healthcare location at time of diagnosis significandy impact rates of SSI, distribution of rates of SSI, and hospital comparative-performance rankings. We believe that public reporting of SSI rates should be limited to complex SSIs diagnosed in the inpatient setting.Infect Control Hosp Epidemiol 2012;33(3):276-282

scholarly journals Surgical Site Infections in orthopaedic patients – a 10-year retrospective observational study in a Polish hospital

2019 ◽  
Author(s):  
Małgorzata Kołpa ◽  
Róża Słowik ◽  
Marta Wałaszek ◽  
Zdzisław Wolak ◽  
Anna Rozanska ◽  
...  
Keyword(s):  
Hip Prosthesis ◽  
Knee Prosthesis ◽  
Surgical Site Infections ◽  
Control Program ◽  
Healthcare Associated Infections ◽  
Orthopaedic Patients ◽  
Before And After ◽  
Hospital Stays ◽  
Healthcare Associated ◽  
Prevention Plan

Abstract INTRODUCTION Surgical site infections (SSIs) are among the most common healthcare-associated infections. They are associated with longer post-operative hospital stays, additional surgical procedures, treatment in intensive care units and higher mortality.MATERIAL AND METHODS Surgical site infections (SSIs) were detected in patients hospitalized in a 40-bed orthopaedics ward via continuous surveillance in 2009–2018. The total number of study patients was 15,678. The results were divided into two 5-year periods before and after the introduction of the SSI prevention plan. The study was conducted as part of a national healthcare-Associated Infections surveillance programme, following the methodology recommended by the HAI-Net, European Centre for Disease Prevention and Control Program (ECDC). RESULTS 168 SSIs were detected in total, including 163 deep SSIs (SSI-D). The total SSI incidence rate was 1.1%, but in hip prosthesis: 1.2%, in knee prosthesis: 1.3%, for open reduction of fracture (FX): 1.3%, for close reduction of fracture (CR): 1.5%, and 0.8% for other procedures. 64% of SSI-D cases required rehospitalisation. A significantly reduction in incidence was found only after fracture reductions: FX and CR, respectively 2.1% vs. 0.7% (OR 3.1 95%CI 1.4-6.6, p<0.01) and 2.1 vs. 0.8% (OR 2.4 95%CI 1.0-5.9, p<0.05). SSI-Ds were usually caused by Gram-positive cocci, specially Staphylococcus aureus, 74 (45.7%); Enterobacteriaceae bacillis accounted for 14.1% and Gram-negative non-fermenting rods for 8.5%. CONCLUSIONS The implemented SSI prevention plan demonstrated a significant decrease (about 2.5-3 times) in SSI-D incidence in fracture reductions. Depending on the epidemiological situation in the ward, it is worthwhile to surveillance of SSIs associated to different types of orthopaedic surgery to assess the risks and take preventive measures.

scholarly journals Making a Case for Adjusting NHSN SSI Risk Stratification Classification for Use of Enhanced Electronic Infection Surveillance

2020 ◽  
Vol 41 (S1) ◽  
pp. s18-s18
Author(s):  
Meri Pearson ◽  
Krista Doline
Keyword(s):  
Healthcare System ◽  
Surveillance System ◽  
Hip Prosthesis ◽  
Knee Prosthesis ◽  
Surgical Site Infections ◽  
Detection Methods ◽  
Surveillance Systems ◽  
Electronic Surveillance ◽  
Healthcare Associated Infection ◽  
Infection Surveillance

Background: A large healthcare system in Georgia went live with an enhanced electronic infection surveillance system in August of 2018. The system was employed at its facilities using a staggered approach. Prior to the implementation of this infection surveillance platform, the healthcare system performed healthcare-associated infection (HAI) surveillance using an in-house culture-based system. The NHSN estimates that culture-based surveillance misses 50%–60% of true surgical site infections (SSIs). Due to the lack of clinical-based detection methods (eg, radiologic imaging), we were unable to appropriately detect all patient harm using the old surveillance system. Method: A retrospective analysis was performed to assess the change in HAI for colon (COLO), abdominal hysterectomy (HYST), hip prosthesis (HPRO), and knee prosthesis (KPRO). SSI cases that met NHSN surveillance criteria were reviewed to determine whether they would have been identified prior to launching the new enhanced electronic surveillance system. Results: Systemwide, 8 of 26 COLO SSIs (31%) and 9 of 18 HYST SSIs (50%) would have not been detected using our old surveillance system. HPRO SSIs and KPRO SSIs identified by our new surveillance system were detected using our old surveillance system, and no change was observed. Conclusion: This analysis showed an increase in COLO SSIs and HYST SSIs from enhanced surveillance. Electronic surveillance systems are not considered as a risk factor in the NHSN annual facility survey that aids in calculating a facility’s standardized infection ratio (SIR). These data help support NHSN consideration of modifying the logistic regression calculation used for the complex SSI models. This revision would allow facilities to compare themselves equitably to those using electronic infection surveillance.Funding: NoneDisclosures: None

Does the use of chlorhexidine gel reduce the frequency of surgical site infections?

2020 ◽  
Vol 92 (2) ◽  
pp. 1-5
Author(s):  
Wojciech Kolasiński ◽  
Lech Pomorski
Keyword(s):  
Total Protein ◽  
Surgical Site Infections ◽  
Fold Increase ◽  
Preoperative Preparation ◽  
Skin Preparation ◽  
Group I ◽  
Duration Of Surgery ◽  
Surgical Field ◽  
Clean Contaminated ◽  
The Impact

Introduction: Surgical site infections (SSI) involve 2-11% of all surgical procedures. Paper assumption: The use of 6% gel with chlorhexidine as an element of preoperative skin preparation of the operated area reduces the number of surgical site infections. The aim of the study was to assess the impact of body mass index (BMI), neutrophil to lymphocyte ratio (NLR), total protein, glucose, length of hospitalization before surgery, duration of surgery, length of drainage maintenance, transfusion of red blood concentrate on the number of SSI. Materials and methods. 248 patients were subjected to prospective analysis. Patients were operated in The General Surgery and Urology Department in Provincial Specialist Hospital in Zgierz. Patients were divided into three groups depending on the microbiological degree of cleanliness of the postoperative wound: Group I - clean wounds, Group II - clean - contaminated wounds, Group III - contaminated wounds, which also included emergency surgery procedures. In each group two subgroups were separated depending on the method of preoperative preparation of the surgical field: A- gel without CHG, B-6% gel with CHG. Results. Surgical site infections were found in 22 patients (8.9%). The respective frequencies for grups I, II, III are: 3.0% vs 12.9% vs 12.7%. An increase in NLR by one unit resulted in a higher incidence of surgical site infections by 11%. A transfusion of RBC to the patient resulted in a 3.5-fold increase in the frequency of surgical site infections. Extending the drain maintenance time by one day increases the SSI frequency by 41%. Lowering the total protein concentration by at least 1 g / dl below normal increases the risk of surgical site infections almost three times. Conclusions. The use of a 6% gel preparation with chlorhexidine as an element of preoperative preparation of the surgical field reduces the risk of surgical site infections, especially in clean-contaminated and contaminated wounds.

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