What is the primary cause of Surgical Site Infections (SSI) according to the evidence?

The primary cause of Surgical Site Infections (SSI) is a break in aseptic technique during the procedure. Maintaining strict aseptic conditions is crucial in preventing infections, as any lapse can introduce pathogens into the surgical site. This includes proper sterilization of instruments, maintaining a sterile field, and proper hand hygiene by the surgical team. When aseptic technique is compromised, bacteria can be deposited directly into the wound, leading to potential infection.

While factors such as inadequate patient preparation, use of contaminated instruments, and prolonged surgical duration can contribute to the overall risk of developing an SSI, they are not considered as primary causes when compared to direct breaches in aseptic technique. For example, patient preparation is important, but it mainly relates to reducing the microbial load before surgery rather than the immediate environmental conditions present during the surgical procedure. Contaminated instruments can lead to infection, but they primarily contribute to a breach in aseptic technique. Prolonged surgical duration may increase the risk of contamination over time but is also secondary to the critical importance of maintaining a sterile environment.