New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective.
Surgical site infections (SSIs) are the most common health-care-associated infections in developing countries, but they also represent a substantial epidemiological burden in high-income countries. The prevention of these infections is complex and requires the integration of a range of preventive measures before, during, and after surgery. No international guidelines are available and inconsistencies in the interpretation of evidence and recommendations in national guidelines have been identified. Considering the prevention of SSIs as a priority for patient safety, WHO has developed evidence-based and expert consensus-based recommendations on the basis of an extensive list of preventive measures. We present in this Review 16 recommendations specific to the intraoperative and postoperative periods. The WHO recommendations were developed with a global perspective and they take into account the balance between benefits and harms, the evidence quality level, cost and resource use implications, and patient values and preferences.
Infection Prevention and Control Global Unit, Service Delivery and Safety, WHO, Geneva, Switzerland. Electronic address: allegranzib@who.int.
Benedetta
B
Allegranzi
Infection Prevention and Control Global Unit, Service Delivery and Safety, WHO, Geneva, Switzerland.
Bassim
B
Zayed
Institute of Hygiene and Environmental Medicine, Charité-University Medicine, Berlin, Germany.
Peter
P
Bischoff
Infection Prevention and Control Global Unit, Service Delivery and Safety, WHO, Geneva, Switzerland.
N Zeynep
NZ
Kubilay
Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands.
Stijn
S
de Jonge
Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands.
Fleur
F
de Vries
OASIS Global, Cincinnati, OH, USA.
Stacey M
SM
Gomes
Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands.
Sarah
S
Gans
Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands.
Elon D
ED
Wallert
Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
Xiuwen
X
Wu
Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
Mohamed
M
Abbas
Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands.
Marja A
MA
Boermeester
Department of Surgery, University of Washington, Seattle, WA, USA.
E Patchen
EP
Dellinger
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Matthias
M
Egger
Institute of Hygiene and Environmental Medicine, Charité-University Medicine, Berlin, Germany.
Petra
P
Gastmeier
Parc Taulí Hospital Universitari, Barcelona, Spain.
Xavier
X
Guirao
Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
Jianan
J
Ren
Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; WHO Collaborating Centre on Patient Safety (Infection Control and Improving Practices), University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
Didier
D
Pittet
OASIS Global, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Joseph S
JS
Solomkin
D032921:Consensus; D019317:Evidence-Based Medicine; D014943:Global Health; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards; D007430:Intraoperative Care; D011182:Postoperative Care; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014944:World Health Organization