Surgical site infection - a European perspective of incidence and economic burden

Int Wound J. 2004 Dec;1(4):247-73. doi: 10.1111/j.1742-4801.2004.00067.x.


This retrospective review of reported surgical site infection (SSI) rates in Europe was undertaken to obtain an estimated scale of the problem and the associated economic burden. Preliminary literature searches revealed incomplete datasets when applying the National Nosocomial Infection Surveillance System criteria. Following an expanded literature search, studies were selected according to the number of parameters reported, from those identified as critical for accurate determination of SSI rates. Forty-eight studies were analysed. None of the reviewed studies recorded all the data necessary to enable a comparative assessment of the SSI rate to be undertaken. The estimated range from selected studies analysed varied widely from 1.5-20% - a consequence of inconsistencies in data collection methods, surveillance criteria and wide variations in the surgical procedures investigated - often unspecified. SSIs contribute greatly to the economic costs of surgical procedures - estimated range: 1.47-19.1 billion Euro dollars. The analysis suggests that the true rate of SSIs, currently unknown, is likely to have been previously under-reported. Consequently, the associated economic burden is also likely to be underestimated. A significant improvement in study design, data collection, analysis and reporting will be necessary to ensure that SSI baseline rates are more accurately assessed to enable the evaluation of future cost-effective measures.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cohort Studies
  • Combined Modality Therapy / methods
  • Cross Infection / diagnosis
  • Cross Infection / economics*
  • Cross Infection / epidemiology*
  • Debridement / adverse effects
  • Debridement / methods
  • Europe / epidemiology
  • Female
  • Health Care Costs
  • Humans
  • Incidence
  • Male
  • Prognosis
  • Reoperation / adverse effects
  • Reoperation / methods
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Surgical Procedures, Operative / adverse effects
  • Surgical Procedures, Operative / methods
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / economics*
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / therapy
  • Treatment Outcome


  • Anti-Bacterial Agents