The Centers for Disease Control and Prevention (CDC) has issued updated evidence-based recommendations for preventing surgical site infections (SSIs). The guidelines cover 14 core areas and are intended for incorporation into existing surgical quality improvement programs for greater patient safety.
Among the updated recommendations:
- Advise patients to have a full-body shower or bath with soap (antimicrobial only as needed) or an antiseptic agent no earlier than the night before the day of surgery.
- Before cesarean delivery, administer antimicrobial prophylaxis before incision.
- In most cases, use an alcohol-based agent for skin preparation in the operating room.
- It is not necessary to use plastic adhesive drapes with or without antimicrobial properties to prevent SSIs.
- For clean and clean-contaminated procedures, do not give additional prophylactic antimicrobial doses after closing the surgical incision, even if the patient has a drain in place.
- Do not apply topical antimicrobial agents to the incision.
- Maintain intraoperative glycemic control in diabetic and nondiabetic patients, targeting blood glucose levels of less than 200 mg/dL.
- Maintain patient normothermia.
- In patients with normal lung function undergoing general anesthesia with endotracheal intubation, administer a higher fraction of inspired oxygen during surgery and after extubation in the immediate postoperative period.
- Do not withhold transfused blood products as a means to prevent SSI.
“As with any guideline, implementation will require consideration of local systems, something quality improvement committees and officers routinely do.”