Perioperative Interventions to Reduce Surgical Site Infections: A Review

Abstract

Surgical site infections (SSIs) contribute to increased health care costs and morbidity after procedures as well as prolonged length of stay. Perioperative personnel can use a variety of interventions to help reduce SSI incidence; however, all strategies are not effective for all patients (eg, antibiotic prophylaxis). Results of randomized controlled trials show that some SSI reduction strategies are generally effective, including preoperative skin antisepsis with an alcohol-based agent, closing surgical wounds with triclosan-coated suture, and applying a negative pressure wound therapy device to open and closed wounds. Study results do not show that irrigating clean wounds with crystalloid solutions containing antibiotics or routinely using plastic drapes with or without impregnated iodophor or silver nylon-impregnated dressings significantly reduces SSI incidence. Perioperative leaders should support the implementation of strategies to prevent SSIs and work with interdisciplinary team members to develop an SSI prevention bundle that will meet the needs of their patients.

Keywords: SSI prevention bundle; negative pressure wound therapy (NPWT); preoperative skin antisepsis; surgical site infection (SSI); triclosan-coated suture (TCS).