A novel classification system, DISH (Dehiscence, Infection, Seroma, Hematoma), standardizes the reporting of surgical site outcomes and has achieved very high inter-rater reliability.

• Consensus definitions for five grades of clinical intervention and four grades of clinical presentation were established through a modified Delphi study involving global experts.
• Mean inter-rater agreement was 0.93, with intra-rater scores at 0.95, indicating excellent reproducibility.

This new framework could enhance the transparency and consistency of reporting surgical complications, facilitating improved outcomes tracking and quality audits across surgical specialties.