Introduction. Surgical site infections (SSIs) are among the healthcare-associated infections (HAIs) targeted by the national program to combat HAIs. Since 1999, a database has been established based on interregional surveillance networks as part of the Healthcare-Associated Infection Alert, Investigation, and Surveillance Network (Raisin). Methods. Each year, elective surgery departments participating in the surveillance network were required to include 200 patients who underwent surgery and collect individual data, including in particular the components of the NNIS risk index (operative time, ASA anesthetic score, contamination class) and other perioperative factors. All included patients were to be followed up, if possible, until the 30th postoperative day. SIS were defined according to standard criteria. Results. A total of 770,176 surgical procedures were monitored between 1999 and 2005. These procedures mainly involved orthopedics (32.8%), gastrointestinal surgery (20.7%), and obstetrics and gynecology (11.5%). This surveillance identified 11,253 SIS (crude incidence rate: 1.46%), 42% of which were deep-site infections. The SSI incidence rate decreased from 2.04% in 1999 to 1.37% in 2005. The incidence of SSIs varied with the NNIS risk index, ranging from 0.9% for low-risk patients (NNIS-0) to 13.3% for the highest-risk patients (NNIS-3). Among NNIS-0 patients, the incidence rate of SIS decreased from 1.1% in 1999 to 0.78% in 2005. The incidence of postoperative infections in the NNIS-0 group decreased between 1999 and 2005 for abdominal wall hernia repairs (-60%), colon surgery (-33%), cesarean sections (-37%), and peripheral vein surgery (-57%). Among the same patients undergoing elective surgery, the incidence of SIS decreased for hernias (-63%), colon surgery (-37%), hip replacements (-71%), cesarean sections (-48%), and peripheral vein surgery (-62%). Conclusion. SSI surveillance is now widespread in France and serves as an important tool for assessing infection risk in surgical patients, taking into account the type of procedure. This surveillance appears to have an impact by reducing the incidence of SSIs following the most common procedures in patients with low infection risk. This impact requires confirmation through follow-up of a cohort of departments that have participated for several consecutive years. The impact of the national program to combat healthcare-associated infections on the incidence of surgical site infections following other procedures or in patients at higher risk remains to be evaluated. (R.A.)