title: [Update of the 2013 consensus conference "Management of the preoperative risk of infection"].
abstract: The surgical site infections (SSI) are rare adverse events that may have severe consequences in terms of morbidity, mortality and costs. Guidelines on the preparation of the patient can reduce the risk of SSI. Previous guidelines were published in 2004.
  
  
  METHODS
  A steering committee and a group of experts were established after seeking professional societies that had participated in the previous guidelines. The working group has defined the objectives of revising and retained two main themes: skin preparation and nasal decolonization of patients with Staphylococcus aureus. We chose to report only the work done on the patient skin preparation. The working group relied on the method of recommendation for clinical practice of the High Authority for Health (HAS). The GRADE approach was used to analyze the articles published since 2004.
  
  
  RESULTS
  It is recommended to perform a preoperative shower but when does not matter. The use of a simple soap seems sufficient. Shampoo does not seem essential nor removal of varnish in the field of urology. Impregnated fabrics, adhesives fields and bacteriological insulating films are of little use to reduce the risk of infection. The depilation is not routinely required. It is recommended to perform a cleansing on contaminated skin. The use of an alcohol antiseptic is preferred, the successive application of two different antiseptics range is possible.
  
  
  CONCLUSIONS
  The updated guidelines on the patient skin preparation before urological surgery was necessary. It changed some guidelines that should appear in our daily practice.
authors: Service d'urologie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Université François-Rabelais de Tours, PRES centre Val-de-Loire université, 37000 Tours, France; Centre d'innovations technologiques, CIC-CIT, CHRU de Tours, 37000 Tours, France. Electronic address: p-urol@orange.fr.
authors: F
authors: F
authors: Bruyère
authors: Service d'épidémiologie et d'hygiène hospitalière, hôpital d'enfants, CHU, 21079 Dijon, France.
authors: A
authors: A
authors: Lefebvre
authors: Service de santé publique, hygiène hospitalière, évaluation, hôpital Morvan, 29609 Brest, France.
authors: P
authors: P
authors: Saliou
authors: Service d'anesthésiologie-réanimation chirurgicale, CHU La Milétrie, 86021 Poitiers, France.
authors: O
authors: O
authors: Mimoz
authors: UHLIN, groupe hospitalier Bichat, Claude-Bernard, HUPNVS, 75877 Paris, France.
authors: J-C
authors: JC
authors: Lucet
authors: Chirurgie thoracique et cardiovasculaire-angiologie, CHU de Limoges, 87042 Limoges, France.
authors: A
authors: A
authors: Le Guyader
authors: Service de neurochirurgie, hôpital Nord, 13915 Marseille, France.
authors: P
authors: P
authors: Roche
authors: Unité de gestion du risque infectieux (UGRI), service de bactériologie-hygiène, CHU, 44093 Nantes, France.
authors: D
authors: D
authors: Lepelletier
authors: Service d'épidémiologie et d'hygiène hospitalière, hôpital d'enfants, CHU, 21079 Dijon, France.
authors: L S
authors: LS
authors: Aho-Glélé
mesh_terms: D006801:Humans; D011300:Preoperative Care / Q000592:standards*; D012308:Risk Management / Q000592:standards*; D013530:Surgical Wound Infection / Q000517:prevention & control*
keywords: Chlorhexidine; Dépilation; Hair removal; Infection site opératoire; Surgical wound infection; Urologie; Urology