Title |
Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017
|
---|---|
Published in |
JAMA Surgery, August 2017
|
DOI | 10.1001/jamasurg.2017.0904 |
Pubmed ID | |
Authors |
Sandra I. Berríos-Torres, Craig A. Umscheid, Dale W. Bratzler, Brian Leas, Erin C. Stone, Rachel R. Kelz, Caroline E. Reinke, Sherry Morgan, Joseph S. Solomkin, John E. Mazuski, E. Patchen Dellinger, Kamal M. F. Itani, Elie F. Berbari, John Segreti, Javad Parvizi, Joan Blanchard, George Allen, Jan A. J. W. Kluytmans, Rodney Donlan, William P. Schecter |
Abstract |
The human and financial costs of treating surgical site infections (SSIs) are increasing. The number of surgical procedures performed in the United States continues to rise, and surgical patients are initially seen with increasingly complex comorbidities. It is estimated that approximately half of SSIs are deemed preventable using evidence-based strategies. To provide new and updated evidence-based recommendations for the prevention of SSI. A targeted systematic review of the literature was conducted in MEDLINE, EMBASE, CINAHL, and the Cochrane Library from 1998 through April 2014. A modified Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence and the strength of the resulting recommendation and to provide explicit links between them. Of 5487 potentially relevant studies identified in literature searches, 5759 titles and abstracts were screened, and 896 underwent full-text review by 2 independent reviewers. After exclusions, 170 studies were extracted into evidence, evaluated, and categorized. Before surgery, patients should shower or bathe (full body) with soap (antimicrobial or nonantimicrobial) or an antiseptic agent on at least the night before the operative day. Antimicrobial prophylaxis should be administered only when indicated based on published clinical practice guidelines and timed such that a bactericidal concentration of the agents is established in the serum and tissues when the incision is made. In cesarean section procedures, antimicrobial prophylaxis should be administered before skin incision. Skin preparation in the operating room should be performed using an alcohol-based agent unless contraindicated. For clean and clean-contaminated procedures, additional prophylactic antimicrobial agent doses should not be administered after the surgical incision is closed in the operating room, even in the presence of a drain. Topical antimicrobial agents should not be applied to the surgical incision. During surgery, glycemic control should be implemented using blood glucose target levels less than 200 mg/dL, and normothermia should be maintained in all patients. Increased fraction of inspired oxygen should be administered during surgery and after extubation in the immediate postoperative period for patients with normal pulmonary function undergoing general anesthesia with endotracheal intubation. Transfusion of blood products should not be withheld from surgical patients as a means to prevent SSI. This guideline is intended to provide new and updated evidence-based recommendations for the prevention of SSI and should be incorporated into comprehensive surgical quality improvement programs to improve patient safety. |
X Demographics
As of 1 July 2024, you may notice a temporary increase in the numbers of X profiles with Unknown location. Click here to learn more.
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 411 | 18% |
Spain | 160 | 7% |
Mexico | 120 | 5% |
United Kingdom | 84 | 4% |
Saudi Arabia | 72 | 3% |
Canada | 62 | 3% |
Colombia | 52 | 2% |
Venezuela, Bolivarian Republic of | 45 | 2% |
Brazil | 32 | 1% |
Other | 443 | 20% |
Unknown | 785 | 35% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 1496 | 66% |
Practitioners (doctors, other healthcare professionals) | 487 | 21% |
Scientists | 236 | 10% |
Science communicators (journalists, bloggers, editors) | 42 | 2% |
Unknown | 5 | <1% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Portugal | 1 | <1% |
Colombia | 1 | <1% |
South Africa | 1 | <1% |
Canada | 1 | <1% |
Spain | 1 | <1% |
Japan | 1 | <1% |
United States | 1 | <1% |
Unknown | 3404 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 351 | 10% |
Other | 333 | 10% |
Student > Postgraduate | 323 | 9% |
Student > Bachelor | 316 | 9% |
Researcher | 290 | 9% |
Other | 669 | 20% |
Unknown | 1129 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 1279 | 37% |
Nursing and Health Professions | 301 | 9% |
Pharmacology, Toxicology and Pharmaceutical Science | 105 | 3% |
Immunology and Microbiology | 58 | 2% |
Engineering | 54 | 2% |
Other | 360 | 11% |
Unknown | 1254 | 37% |