Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Belinda De Simone¹, Massimo Sartelli², Federico Coccolini³, Chad G Ball⁴, Pietro Brambillasca⁵, Massimo Chiarugi⁶, Fabio Cesare Campanile⁷, Gabriela Nita⁸, Davide Corbella⁵, Ari Leppaniemi⁹, Elena Boschini¹⁰, Ernest E Moore¹¹, Walter Biffl¹², Andrew Peitzmann¹³, Yoram Kluger¹⁴, Michael Sugrue¹⁵, Gustavo Fraga¹⁶, Salomone Di Saverio¹⁷, Dieter Weber¹⁸, Boris Sakakushev¹⁹, Osvaldo Chiara²⁰, Fikri M Abu-Zidan²¹, Richard Ten Broek²², Andrew W Kirkpatrick²³, Imtiaz Wani²⁴, Raul Coimbra²⁵, Gian Luca Baiocchi²⁶, Micheal D Kelly²⁷, Luca Ansaloni²⁸, Fausto Catena²⁹

Affiliations

¹ Department of General Surgery, Azienda USL-IRCSS di Reggio Emilia, Guastalla Hospital, Via Donatori di sangue 1, 42016, Guastalla, RE, Italy. desimone.belinda@gmail.com.
² Department of General Surgery, Macerata Hospital, 62100, Macerata, Italy.
³ General, Emergency and Trauma Surgery, Pisa University Hospital, 56124, Pisa, Italy.
⁴ Department of Surgery and Oncology, Hepatobiliary and Pancreatic Surgery, Trauma and Acute Care Surgery, University of Calgary Foothills Medical Center, Calgary, Alberta, T2N 2T9, Canada.
⁵ Anesthesia and Critical Care Department, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128, Bergamo, Italy.
⁶ Emergency Surgery Unit and Trauma Center, Cisanello Hospital, Pisa, Italy.
⁷ Fabio Cesare Campanile, Ospedale Andosilla, Civita Castellana, Italy.
⁸ Unit of General Surgery, Castelnuovo ne'Monti Hospital, AUSL, Reggio Emilia, Italy.
⁹ Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland.
¹⁰ Medical Library, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128, Bergamo, Italy.
¹¹ Ernest E Moore Shock Trauma Center at Denver Health and University of Colorado, Denver, USA.
¹² Trauma and Acute Care Surgery, Scripps memorial Hospital, La Jolla, CA, USA.
¹³ Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, USA.
¹⁴ Division of General Surgery, Rambam Health Care Campus, Haifa, Israel.
¹⁵ Department of Surgery, Letterkenny University Hospital and Donegal Clinical Research Academy, Letterkenny, Ireland.
¹⁶ Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
¹⁷ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
¹⁸ Trauma and General Surgery, Royal Perth Hospital, Perth, Australia.
¹⁹ University Hospital St George First, Clinic of General Surgery, Plovdiv, Bulgaria.
²⁰ State University of Milan, Acute Care Surgery Niguarda Hospital, Milan, Italy.
²¹ Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
²² Radboud University Nijmegen, Nijmegen, The Netherlands.
²³ Foothills Medical Centre and the University of Calgary, Calgary, AB, Canada.
²⁴ Department of Minimal Access and General Surgery, Government Gousia Hospital, Sringar, Kashmir, India.
²⁵ Department of Surgery, UC San Diego Medical Center, San Diego, USA.
²⁶ Department of Surgery, University of Brescia, Brescia, Italy.
²⁷ Department of General Surgery, Albury Hospital, Albury, NSW, 2640, Australia.
²⁸ Department of Emergency and Trauma Surgery, Bufalini Hospital, 47521, Cesena, Italy.
²⁹ Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100, Parma, Italy.

PMID: 32041636
PMCID: PMC7158095
DOI: 10.1186/s13017-020-0288-4

Review

Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Belinda De Simone et al. World J Emerg Surg. 2020.

. 2020 Feb 10;15(1):10.

doi: 10.1186/s13017-020-0288-4.

Authors

Affiliations

¹ Department of General Surgery, Azienda USL-IRCSS di Reggio Emilia, Guastalla Hospital, Via Donatori di sangue 1, 42016, Guastalla, RE, Italy. desimone.belinda@gmail.com.
² Department of General Surgery, Macerata Hospital, 62100, Macerata, Italy.
³ General, Emergency and Trauma Surgery, Pisa University Hospital, 56124, Pisa, Italy.
⁴ Department of Surgery and Oncology, Hepatobiliary and Pancreatic Surgery, Trauma and Acute Care Surgery, University of Calgary Foothills Medical Center, Calgary, Alberta, T2N 2T9, Canada.
⁵ Anesthesia and Critical Care Department, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128, Bergamo, Italy.
⁶ Emergency Surgery Unit and Trauma Center, Cisanello Hospital, Pisa, Italy.
⁷ Fabio Cesare Campanile, Ospedale Andosilla, Civita Castellana, Italy.
⁸ Unit of General Surgery, Castelnuovo ne'Monti Hospital, AUSL, Reggio Emilia, Italy.
⁹ Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland.
¹⁰ Medical Library, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128, Bergamo, Italy.
¹¹ Ernest E Moore Shock Trauma Center at Denver Health and University of Colorado, Denver, USA.
¹² Trauma and Acute Care Surgery, Scripps memorial Hospital, La Jolla, CA, USA.
¹³ Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, USA.
¹⁴ Division of General Surgery, Rambam Health Care Campus, Haifa, Israel.
¹⁵ Department of Surgery, Letterkenny University Hospital and Donegal Clinical Research Academy, Letterkenny, Ireland.
¹⁶ Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
¹⁷ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
¹⁸ Trauma and General Surgery, Royal Perth Hospital, Perth, Australia.
¹⁹ University Hospital St George First, Clinic of General Surgery, Plovdiv, Bulgaria.
²⁰ State University of Milan, Acute Care Surgery Niguarda Hospital, Milan, Italy.
²¹ Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
²² Radboud University Nijmegen, Nijmegen, The Netherlands.
²³ Foothills Medical Centre and the University of Calgary, Calgary, AB, Canada.
²⁴ Department of Minimal Access and General Surgery, Government Gousia Hospital, Sringar, Kashmir, India.
²⁵ Department of Surgery, UC San Diego Medical Center, San Diego, USA.
²⁶ Department of Surgery, University of Brescia, Brescia, Italy.
²⁷ Department of General Surgery, Albury Hospital, Albury, NSW, 2640, Australia.
²⁸ Department of Emergency and Trauma Surgery, Bufalini Hospital, 47521, Cesena, Italy.
²⁹ Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100, Parma, Italy.

PMID: 32041636
PMCID: PMC7158095
DOI: 10.1186/s13017-020-0288-4

Erratum in

Correction to: Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines.
De Simone B, Sartelli M, Coccolini F, Ball CG, Brambillasca P, Chiarugi M, Campanile FC, Nita G, Corbella D, Leppaniemi A, Boschini E, Moore EE, Biffl W, Peitzmann A, Kluger Y, Sugrue M, Fraga G, Di Saverio S, Weber D, Sakakushev B, Chiara O, Abu-Zidan FM, Ten Broek R, Kirkpatrick AW, Wani I, Coimbra R, Baiocchi GL, Kelly MD, Ansaloni L, Catena F. De Simone B, et al. World J Emerg Surg. 2021 Apr 14;16(1):18. doi: 10.1186/s13017-021-00361-4. World J Emerg Surg. 2021. PMID: 33853621 Free PMC article. No abstract available.

Abstract

Background: Surgical site infections (SSI) represent a considerable burden for healthcare systems. They are largely preventable and multiple interventions have been proposed over past years in an attempt to prevent SSI. We aim to provide a position paper on Operative Room (OR) prevention of SSI in patients presenting with intra-abdominal infection to be considered a future addendum to the well-known World Society of Emergency Surgery (WSES) Guidelines on the management of intra-abdominal infections.

Methods: The literature was searched for focused publications on SSI until March 2019. Critical analysis and grading of the literature has been performed by a working group of experts; the literature review and the statements were evaluated by a Steering Committee of the WSES.

Results: Wound protectors and antibacterial sutures seem to have effective roles to prevent SSI in intra-abdominal infections. The application of negative-pressure wound therapy in preventing SSI can be useful in reducing postoperative wound complications. It is important to pursue normothermia with the available resources in the intraoperative period to decrease SSI rate. The optimal knowledge of the pharmacokinetic/pharmacodynamic characteristics of antibiotics helps to decide when additional intraoperative antibiotic doses should be administered in patients with intra-abdominal infections undergoing emergency surgery to prevent SSI.

Conclusions: The current position paper offers an extensive overview of the available evidence regarding surgical site infection control and prevention in patients having intra-abdominal infections.

Keywords: Emergency; Intra-abdominal infection; Operating room; Prevention; Surgical site infection.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

1. Al-Dabbagh MA, Dobson S. The evidence behind prophylaxis and treatment of wound infection after surgery. Adv Exp Med Biol. 2013;764:141-150. Review. - PubMed
1. Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999;20(11):725–730. doi: 10.1086/501572. - DOI - PubMed
1. de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB.Surgical site infection: incidence and impact on hospital utilization and treatment costs.Am J Infect Control 2009;37(5):387-397. doi: 10.1016/j.ajic.2008.12.010. Epub 2009 Apr 23. - PubMed
1. Anderson DJ, Podgorny K, Berrios-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35:605e627. doi: 10.1086/676022. - DOI - PMC - PubMed
1. Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70:195e283. doi: 10.2146/ajhp120568. - DOI - PubMed

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Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Affiliations

Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Miscellaneous