Surgical Site Infection Prevention Guidelines Issued By CDC

Federal health officials have released new guidelines designed to reduce the risk of surgical site infection, outlining the best practices hospitals and medical providers should follow for individuals who recently had surgery. 

The U.S. Centers for Disease Control and Prevention (CDC) has issued the recommendations based on a review of nearly 5,500 relevant studies, which were conducted from 1998 to 2014, focusing on post-surgery infections. The guidelines were published this month in the medical journal JAMA Surgery.

CDC researchers estimate half of surgical site infections are preventable using simple evidence-based procedures. However, roughly half of all surgical site infections do not become evident until after the patient is discharged from the hospital.

The guidelines focus mainly on surgical prep and postoperative procedures that are designed to help reduce the risk of infection at surgical sites and incisions.

Researchers recommend patients shower or bathe before surgery, with either antimicrobial soap or non-antimicrobial soap. They could also use an antiseptic agent on their skin the night before the surgery.

An antibacterial solution should be used to swab the entire body before surgery only when indicated for specific surgeries, based on published clinical guidelines. However, the antibacterial solution should be timed properly to ensure a significant concentration is on the tissue when the actual incision is made.

During cesarean section deliveries, antibacterial solutions should be administered directly before the skin incision.

The recommendations also call for skin preparation in the operating room, using an alcohol-based solution. A topical antimicrobial should not be applied to the surgical incision; however, doctors should consider the use of triclosan coated sutures to prevent infections.

Other measures that should be considered include glycemic control during surgery. The CDC guidelines call for healthcare providers to begin using blood glucose target levels less than 200 mg/dL.

Additional measures include regularly monitoring a patient’s body temperature to maintain a normal temperature, and an increased fraction of inspired oxygen, or higher oxygen content, should be used during surgery and after the patient is extubated.

“This guideline is intended to provide new and updated evidence-based recommendations for the prevention of [surgical site infections] and should be incorporated into comprehensive surgical quality improvement programs to improve patient safety,” CDC researchers wrote.

Another study published in the journal for the American College of Surgeons indicated using emails and text messages to remind patients to perform preoperative antiseptic showers prior to surgery can significantly reduce surgical site infections.

A 2014 study indicated good surgical practices can help reduce infections by more than 77 percent. Effective practices included washing hands before touching dressings, leaving a dressing on for 72 hours, normalizing body temperature and focusing on blood glucose levels.