Updated CDC guidelines to prevent surgical site infections

Health Care Comments Off

Surgical site infections (SSIs) are preventable healthcare-associated infections, also called nosocomial infections. They rank among the top five healthcare-associated infections, besides ventilator-associated pneumonia, central line–associated bloodstream infections, Clostridium difficile infections and catheter–associated urinary tract infections. SSIs not only increase costs of health care, but also the associated morbidity and mortality for the patient. Preventing SSIs is therefore important.

For the first time since 1999, the Centers for Disease Control and Prevention (CDC) has issued updated evidence-based recommendations for preventing surgical site infections (SSIs),. These recommendations are published online May 3, 2017 in JAMA Surgery. Some key new and updated recommendations include:

• Patients should be advised to shower or bathe (full body) with soap (antimicrobial or nonantimicrobial) or an antiseptic agent on at least the night before the day of the surgery.
• Antimicrobial prophylaxis should be administered only when indicated. The timing of the antimicrobial should ensure a bactericidal concentration in the serum and tissues at the time of the incision.
• Administer antimicrobial prophylaxis in cesarean section just before skin incision.
• Use an alcohol-based agent for skin preparation in the operating room, unless contraindicated.
• For clean and clean-contaminated procedures, additional prophylactic antimicrobial agent doses is not recommended after closing the surgical incision should not be administered in the OR after the surgical incision is closed, even if a drain has been put.
• Do not apply topical antimicrobial agents to the surgical incision.
• Target a blood glucose level less than 200 mg/dL during surgery.
• Maintain normothermia in all patients.
• A higher fraction of inspired oxygen during surgery and after extubation in the immediate postoperative period should be administered in patients with normal pulmonary function undergoing general anesthesia with endotracheal intubation.
• Do not withhold transfusion of blood products sin order to prevent SSI.

(Source: JAMA Surgery)

Dr KK Aggarwal
National President IMA & HCFI