Surgical Site Infections
Key Points
Î Surgical site infections (SSIs) occur in 2%-5% of patients undergoing
inpatient surgery.
Î Approximately 160,000-300,000 SSIs occur each year in the US.
Î SSI is now the most common and most costly hospital-acquired infection.
Î Up to 60% of SSIs have been estimated to be preventable by using
evidence-based guidelines.
Basic Practices for Preventing SSI
Î Administer antimicrobial prophylaxis according to evidence-based
standards and guidelines (I).
• Adjust dosing on the basis of patient weight.
• Redose prophylactic antimicrobial agents for long procedures and in cases with
excessive blood loss during the procedure.
• Use a combination of parenteral antimicrobial agents and oral antimicrobials to
reduce the risk of SSI following colorectal procedures.
Î DO NOT remove hair at the operative site unless the presence of hair
will interfere with the operation. Do not use razors (I).
Î Control blood glucose during the immediate postoperative period for
cardiac surgery patients (I) and noncardiac surgery patients (II).
Î Maintain normothermia (temperature of 35.5°C or more) during the
perioperative period (I).
Î Optimize tissue oxygenation by administering supplemental oxygen
during and immediately following surgical procedures involving
mechanical ventilation (I).
Î Use alcohol-containing preoperative skin preparatory agents if no
contraindication exists (I).
Î Use impervious plastic wound protectors for gastrointestinal and
biliary tract surgery (I).
Î Use a checklist based on the WHO checklist to ensure compliance with
best practices to improve surgical patient safety (I).
Î Perform surveillance for SSI (II).
• Identify, collect, store, and analyze data needed for the surveillance program.
• Perform postoperative surveillance for 30 days; extend the postoperative
surveillance period to 90 days for certain procedure categories.
• Surveillance should be performed on patients readmitted to the hospital.
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