During surgical site infection surveillance, a patient who underwent open abdominal hernia repair with insertion of synthetic mesh presents on postoperative day 72 with purulent drainage from the wound, erythema, and dehiscence involving the fascia and muscle layer. Under CDC surveillance criteria, this infection is classified as:

• A Superficial incisional SSI, reportable within 30 days
• B Not a reportable SSI, because day 72 exceeds the 30-day surveillance period
• C Organ or space SSI because mesh constitutes a body space
• D Deep incisional SSI, reportable because the 90-day surveillance window applies when an implant is present ✓

Explanation

Superficial and deep incisional SSIs occurring without an implant are surveilled for 30 days, but when an implant such as prosthetic mesh is in place the surveillance window extends to 90 days. Involvement of fascial and muscle layers defines a deep incisional SSI. Organ or space SSI refers to infection of anatomical structures manipulated during surgery, not to implanted foreign material, which rules out option C.

Reference: CDC Guideline for the Prevention of Surgical Site Infection, 2017 ed.

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Written and medically reviewed by the StethoPrep medical team.