New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective.
Surgical site infections (SSIs) are among the most preventable health-care-associated infections and are a substantial burden to health-care systems and service payers worldwide in terms of patient morbidity, mortality, and additional costs. SSI prevention is complex and requires the integration of a range of measures before, during, and after surgery. No international guidelines are available and inconsistencies in the interpretation of evidence and recommendations of national guidelines have been identified. Given the burden of SSIs worldwide, the numerous gaps in evidence-based guidance, and the need for standardisation and a global approach, WHO decided to prioritise the development of evidence-based recommendations for the prevention of SSIs. The guidelines take into account the balance between benefits and harms, the evidence quality, cost and resource use implications, and patient values and preferences. On the basis of systematic literature reviews and expert consensus, we present 13 recommendations on preoperative preventive measures.
Infection Prevention and Control Global Unit, Service Delivery and Safety, WHO, Geneva, Switzerland. Electronic address: allegranzib@who.int.
Benedetta
B
Allegranzi
Institute of Hygiene and Environmental Medicine, Charité-University Medicine, Berlin, Germany.
Peter
P
Bischoff
Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands.
Stijn
S
de Jonge
Infection Prevention and Control Global Unit, Service Delivery and Safety, WHO, Geneva, Switzerland.
N Zeynep
NZ
Kubilay
Infection Prevention and Control Global Unit, Service Delivery and Safety, WHO, Geneva, Switzerland.
Bassim
B
Zayed
OASIS Global, Cincinnati, OH, USA.
Stacey M
SM
Gomes
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.
Jasper J
JJ
Atema
Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands.
Sarah
S
Gans
Amphia Hospital Breda, Breda, Netherlands.
Miranda
M
van Rijen
Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands.
Marja A
MA
Boermeester
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Matthias
M
Egger
Amphia Hospital Breda, Breda, Netherlands; University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands.
Jan
J
Kluytmans
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; Department of Surgery, 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; D017410:Practice Guidelines as Topic; D011300:Preoperative Care; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000191:economics / Q000517:prevention & control*; D014944:World Health Organization