title: Prevention of surgical site infections in orthopaedic surgery and bone trauma: state-of-the-art update.
abstract: Prevention of surgical site infection in orthopaedic surgery and bone trauma has some hallmarks not shared with other surgical disciplines: low inoculum for implant infections; pathogenicity of coagulase-negative staphylococci and other skin commensals; possible haematogenous origin; and long post-discharge surveillance periods. Only some of the many measures to prevent orthopaedic surgical site infection are based on strong evidence and there is insufficient evidence to show which element is superior over any other. This highlights the need for multimodal approaches involving active post-discharge surveillance, as well as preventive measures at every step of the care process. These range from preoperative care to surgery and postoperative care at the individual patient level, including department-wide interventions targeting all healthcare-associated infections and improving antibiotic stewardship. Although theoretically reducible to zero, the maximum realistic extent to decrease surgical site infection in elective orthopaedic surgery remains unknown.
authors: Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, University of Geneva, 4 Rue Gabrielle Perret-Gentil, Geneva, Switzerland. ilker.uckay@hcuge.ch
authors: I
authors: I
authors: Uçkay
authors: P
authors: P
authors: Hoffmeyer
authors: D
authors: D
authors: Lew
authors: D
authors: D
authors: Pittet
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D055317:Evidence-Based Practice; D050723:Fractures, Bone / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000254:growth & development; D006801:Humans; D009985:Orthopedics; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents