4
Recommendations
Table 1. Recommendations to Prevent Surgical Site
Infections (SSIs)
Essential Practices: should be adopted by all acute-care hospitals unless a clear
and compelling rationale for an alternative approach is present
1. Administer antimicrobial prophylaxis according to evidence-based standards and
guidelines. (H)
2. Use a combination of parenteral and oral antimicrobial prophylaxis prior to elective
colorectal surgery to reduce the risk of SSI. (H)
3. Decolonize surgical patients with an anti-staphylococcal agent in the preoperative
setting for orthopedic and cardiothoracic procedures. (H)
Decolonize surgical patients in other procedures at high risk of staphylococcal SSI,
such as those involving prosthetic material. (L)
4. Use antiseptic-containing preoperative vaginal preparation agents for patients
undergoing cesarean delivery or hysterectomy. (M)
5. Do not remove hair at the operative site unless the presence of hair will interfere
with the surgical procedure. (M)
6. Use alcohol-containing preoperative skin preparatory agents in combination with
an antiseptic. (H)
7. For procedures not requiring hypothermia, maintain normothermia (temperature
>35.5°C) during the perioperative period. (H)
8. Use impervious plastic wound protectors for gastrointestinal and biliary tract
surgery. (H)
9. Perform intraoperative antiseptic wound lavage. (M)
10. Control blood-glucose level during the immediate postoperative period for all
patients. (H)
11. Use a checklist and/or bundle to ensure compliance with best practices to improve
surgical patient safety. (H)
12. Perform surveillance for SSI. (M)
13. Increase the efficiency of surveillance by utilizing automated data. (M)
14. Provide ongoing SSI rate feedback to surgical and perioperative personnel and
leadership. (M)
15. Measure and provide feedback to healthcare personnel (HCP) regarding rates of
compliance with process measures. (L)
16. Educate surgeons and perioperative personnel about SSI prevention measures. (L)
