Preventing surgical site infections.
The risk of surgical site infection (SSI) is approximately 1-3% for elective clean surgery. Apart from patient endogenous factors, the role of external risk factors in the pathogenesis of SSI is well recognized. However, among the many measures to prevent SSI, only some are based on strong evidence, for example, adequate perioperative administration of prophylactic antibiotics, and there is insufficient evidence to show whether one method is superior to any other. This highlights the need for a multimodal approach involving active post-discharge surveillance, as well as measures at every step of the care process, ranging from the operating theater to postoperative care. Multicenter or supranational intervention programs based on evidence-based guidelines, 'bundles' or safety checklists are likely to be beneficial on a global scale. Although theoretically reducible to zero, the maximal realistic extent by which SSI can be decreased remains unknown.
Uçkay
Ilker
I
Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle Perret-Gentil, 1211 Geneva 14, Switzerland.
Harbarth
Stephan
S
Peter
Robin
R
Lew
Daniel
D
Hoffmeyer
Pierre
P
Pittet
Didier
D
D019072:Antibiotic Prophylaxis; D057189:Checklist; D006235:Hand Disinfection; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards; D007431:Intraoperative Complications / Q000517:prevention & control; D009873:Operating Rooms; D019990:Perioperative Care; D011182:Postoperative Care; D017410:Practice Guidelines as Topic; D011786:Quality Control; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*