Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017

Abstract

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.

Comparação das taxas de infecção cirúrgica após implantação do checklist de segurança

“…( [1][2][3] Although the evidence is well defined, the adherence to these measures in hospital practice turns out to be a challenge due to the complexity of the system, the limitation of human resources, materials and equipment, workload, lack of knowledge, and inefficient management, among other factors.…”

“…(1,2) Among the HAIs, surgical site infection (SSI) has a prominent role, which can be manifested up to 30 days after surgery, or up to 90 days after if an implant is used, and are classifi ed according to the degree of involvement, namely: superfi cial incision, deep incision, or organ and/or space infection. (3,4) Surgical site infection is one of the main targets of epidemiological surveillance in health institutions. In underdeveloped and developing countries, it is estimated that SSI can aff ect up to onethird of patients undergoing surgical procedures and, although less frequent in industrialized countries, it is the second among the HAIs in Europe and the United States.…”

“…(5,6) Approximately 50 -60% of SSI are preventable by means of evidence-based strategies. (3) Surgeries are classifi ed as, according to the potential for contamination of the site handled: clean, potentially contaminated, contaminated, and infected wounds. (4) Clean wound surgeries are those performed on sterile or decontaminated tissue in the absence of local infectious and infl ammatory processes or gross technical failures; elective and traumatic surgeries with fi rst intention healing and without drainage; or surgeries in which no penetration of the digestive, respiratory or urinary tract occurs.…”

“…(4) Clean wound surgeries are those performed on sterile or decontaminated tissue in the absence of local infectious and infl ammatory processes or gross technical failures; elective and traumatic surgeries with fi rst intention healing and without drainage; or surgeries in which no penetration of the digestive, respiratory or urinary tract occurs. (3) Th ese are the recommended and prioritized procedures for surgical surveillance, and, in general, the acceptable SSI rates range from 1 -5%. Th e monitoring of this indicator enables an indirect evaluation of items potentially related to the infection.…”

Surgical Site Infection Prevention

“…If hands are soiled, they should be washed again with an antiseptic surgical solution because although alcohol rapidly kills microorganisms, it does not physically remove organic material. Studies have shown that waterless chlorhexidine scrub is as effective as traditional waterbased scrubs and requires less time and having a persistent suppressive effect against bacterial regrowth on the skin, potentially lasting throughout several operations [1,2].…”