Appropriate Use Criteria

Assumptions

1. The patient has previously undergone surgical intervention and is suspected as having a subsequent surgical site infection.  
2. This AUC only covers the initial presentation and definitive treatment of a surgical site infection; definitive treatment does not include other decompressive/precursory surgical procedures prior to the definitive treatment plan.
3. Physical examination suggesting infection include but are not limited to: erythema, persistent wound drainage, pus, and/or foul odor.
4. All patients will be monitored for ongoing infection after treatment.
5. Use of this AUC assumes that diagnostic procedures (cultures and organism characterization) have been performed.
6. Infectious Disease Consult should be ordered as appropriate on a case-by-case basis.
7. Plastic Surgery Consult should be ordered as appropriate on a case-by-case basis.
8. There may be patients where a salvage treatment (definitive resection arthroplasty, fusion, amputation) is the most appropriate treatment, but due to its rarity, salvage treatments are not included as a treatment option in this AUC.
9. Surgical debridement should occur with all implant removals and retentions.
10. Antibiotic management (intravenous, oral and local) is at the discretion of the surgeon and/or infectious disease specialist.
11. It is possible that more than one treatment is appropriate for a patient.
12. This AUC does not apply to spine surgery.

Disclaimer:

Volunteer physicians from multiple medical specialties created and categorized these Appropriate Use Criteria. These Appropriate Use Criteria are not intended to be comprehensive or a fixed protocol, as some patients may require more or less treatment or different means of diagnosis. These Appropriate Use Criteria represent patients and situations that clinicians treating or diagnosing musculoskeletal conditions are most likely to encounter. The clinician’s independent medical judgment, given the individual patient’s clinical circumstances, should always determine patient care and treatment.