SSI Surveillance

Clinical Objective

Conduct systematic postoperative surveillance for surgical site infection using standardized definitions, defined monitoring windows, and a case review mechanism that captures infections occurring at or after the first recheck. Non-implant cases require a minimum 30-day surveillance window; implant cases require surveillance of one year or longer per CDC criteria. Surveillance data drives protocol evaluation and SSI rate benchmarking.

Why This Matters

SSI rates are meaningless without systematic surveillance. Infections detected opportunistically (owner calls because wound is open) represent only a fraction of true SSI burden. Surveillance that includes active follow-up at defined intervals captures the full incidence and enables accurate trend analysis, protocol evaluation, and regulatory reporting where required.

Critical Control Points

• Standardized SSI definition applied consistently — use CDC NHSN criteria adapted for veterinary practice

• All surgical cases entered into the surveillance denominator at the time of surgery

• Surveillance window: 30 days for non-implant; up to 1 year for implant cases

• Active follow-up: do not rely solely on owner-reported events — schedule rechecks

• SSI confirmed cases trigger a case review within 30 days of identification

SSI Surveillance Program Checklist

Use this checklist to establish and maintain your SSI surveillance program. All surgical cases must be entered into the denominator at the time of surgery.

Surveillance Database Entry (Per Case)

Step-by-Step Protocol

1. 1

   Enter all surgical cases into the surveillance denominator log at the time of surgery, recording procedure type, implant use, risk classification, and antibiotic prophylaxis received

2. 2

   Apply the standard SSI surveillance window: 30 days for non-implant procedures, 90 days for implant procedures without residency, 1 year for implant procedures with residency (e.g., joint replacements)

3. 3

   Schedule active surveillance contacts at defined intervals: first recheck at day 3-5, suture removal at day 10-14, and implant rechecks per schedule

4. 4

   At each surveillance contact, apply the standardized SSI assessment: wound appearance, discharge, swelling, fever, pain — document findings against case record

5. 5

   Classify any suspected infection using the adapted CDC criteria: superficial incisional, deep incisional, or organ/space SSI

6. 6

   Enter confirmed SSIs into the surveillance database with date of detection, classification, organism if cultured, and treatment initiated

7. 7

   Review monthly SSI rate data and report to clinical team quarterly; trigger case review for all confirmed SSIs

Key Pitfalls

• Failing to define the denominator — without knowing how many cases were performed, an SSI count is uninterpretable

• Using inconsistent SSI definitions, making trend data unreliable and comparisons impossible

• Surveillance window cut off at suture removal — implant infections commonly present after 30 days

• Relying on owner-reported infections only — passive surveillance dramatically underestimates true SSI rate

• Confirmed SSIs not triggering a formal case review, missing the learning opportunity