Barriers to detection of an SSI after discharge:
(1) lack of time or personnel to perform adequate followup
(2) failure to make the diagnosis of a surgical site infection (especially if onset delayed)
(3) failure of the treating physician or facility notifying the surgeon
(4) transitional living arrangement
(5) homelessness
(6) traveling to distant home (college student, traveler, etc)
(7) language barriers
(8) inability to contact by mail, phone or email (incorrect information, not available, or failure to respond)
(9) substance abuse
(10) intellectual barriers
(11) medical insurance fraud (patient using someone else's insurance)
(12) conflict between the patient and the facility or surgeon
As much information as possible should be collected and verified prior to discharge.
