[Surgical site infections: what about the children?]

Surgical site infections (SSIs) are uniformly defined for adults and children as infections that develop within 30 days after an operation and are classified as being either incisional or organ/space in the operated area. SSI rates among children are similar to adults, but are higher among neonates. SSIs represent a significant burden in terms of patient morbidity and mortality, length of hospitalization and cost to the health services. The difficulty in treatment and prevention of SSIs usually results from the variety of pathogens causing the infection. There are a multitude of risk factors influencing the development of SSIs that may be related to patient characteristics, such as younger age, and/or the surgical procedure, such as duration of surgery, wound class, and surgical technique. The prognostic scores which, to the best of our knowledge, have been developed and validated for adults, are yet to be adopted for children. Prevention of SSIs requires addressing the causes at each phase of patient treatment, uniformly for both adults and children. Guidelines for the prevention of SSIs have been developed; however, they are not specifically related to the pediatric patients and are not fully supported by evidence. For instance, management of prophylactic antibiotics is a standard for adults, but there is no clear agreement for children, and use of antibiotic prophylactics varies between medical centers. In summary, a systematic registry of SSIs among children in Israel is required along side of rigorous investigation of the risk factors and prevention program development.