7
Table 2. Selected Risk Factors for and Recommendations
to Prevent SSI
Risk Factor Recommendation
Quality of
Evidence
Operative characteristics
Surgical scrub
(surgical team
members' hands
and forearms)
Use appropriate antiseptic agent to perform
preoperative surgical scrub. For most products, scrub
the hands and forearms for 2–5 minutes.
M
Skin preparation Wash and clean skin around incision site. Use a
dual agent skin prep containing alcohol unless
contraindications exist.
H
Antimicrobial
prophylaxis
Administer only when indicated. Select appropriate
agents based on surgical procedure, most common
pathogens causing SSI for a specific procedure, and
published recommendations. Administer within 1
hour of incision to maximize tissue concentration.
Discontinue antimicrobial agents aer incisional
closure in the operating room.
a
H
Blood transfusion Blood transfusions increase the risk of SSI by
decreasing macrophage function. Limit blood loss
and need for blood transfusion to the greatest extent
possible.
M
Surgeon skill/
technique
Handle tissue carefully and eradicate dead space. L
Appropriate
gloving
All members of the operative team should double
glove and change gloves when perforation is noted.
L
Asepsis Adhere to standard principles of operating room
asepsis.
L
Operative time No formal recommendation. Minimize as much as
possible without sacrificing surgical technique and
aseptic practice.
H
Operating room characteristics
Ventilation Follow ANSI/ASHRAE/ASHE Standard 170
recommendations
b
for proper air handling in the
operating room.
L
Traffic Minimize operating room traffic. L
(cont'd)
