Background: Surgical site infections (SSIs) remain among the most frequent complications of
surgery. Surgery is the mainstay of treatment in the majority of cases, but antimicrobial therapy
is required for some indications
Methods: Selective review of the literature to provide an up-to-date overview of the diagnostic
criteria and different treatment options pertaining to the various forms of SSIs. Only
articles published in English and listed in MEDLINE/PubMed were reviewed. Special attention
was given to antimicrobial chemotherapy of established SSIs
Results: Following a consensus meeting in 1992, SSIs were categorized by the U.S. Centers
for Disease Control and Prevention (CDC) into superficial and deep incisional and
organ/space types. Whereas superficial SSIs usually require only opening and drainage of the
incision, deep incisional SSIs require urgent surgical débridement and usually necessitate antibiotic
therapy. Vacuum-assisted closure of open wounds is promoted for a variety of indications,
but lacks evidence from randomized controlled trials in patients with SSIs.
Organ/space or intracavitary SSIs comprise a number of different infectious complications,
most of which require direct surgical or interventional radiologic therapy to ensure control
of the source
Conclusions: Surgical therapy remains the treatment of choice for SSIs, but deep incisional
and organ/space SSIs often require adjunctive antimicrobial therapy for optimal outcomes.
Increasing resistance patterns have led to the development of new classes of antibiotics effective
against problem pathogens such as methicillin-resistant Staphylococcus aureus or coagulase-
negative staphylococci
