Updated Recommendations for Control of Surgical Site Infections.

sas-schatzi

Working on something. Hope to get back to this. There is an update for 2015 by this same author, but couldn't access it yet.

http://www.ncbi.nlm.nih.gov/pubmed/21587113

Ann Surg. 2011 Jun;253(6):1082-93. doi: 10.1097/SLA.0b013e31821175f8.

Updated recommendations for control of surgical site infections.

Alexander JW¹, Solomkin JS, Edwards MJ.

Abstract

OBJECTIVE:

The objective of this study is to provide updated guidelines for the prevention of surgical wound infections based upon review and interpretation of the current and past literature.

BACKGROUND:

The development and treatment of surgical wound infections has always been a limiting factor to the success of surgical treatment. Although continuous improvements have been made, surgical site infections continue to occur at an unacceptable rate, annually costing billions of dollars in economic loss caused by associated morbidity and mortality.

METHODS:

The Centers for Disease Control (CDC) provided extensive recommendations for the control of surgical infections in 1999. Review of the current literature with interpretation of the findings has been done to update the recommendations.

RESULTS:

New and sometimes conflicting studies indicate that coordination and application of techniques and procedures to decrease wound infections will be highly successful, even in patients with very high risks.

CONCLUSIONS:

This review suggests that uniform adherence to the proposed guidelines for the prevention of surgical infections could reduce wound infections significantly; namely to a target of less than 0.5% in clean wounds, less than 1% in clean contaminated wounds and less than 2% in highly contaminated wounds and decrease related costs to less than one-half of the current amount

sas-schatzi

http://www.ncbi.nlm.nih.gov/pubmed/22736119

Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Jun;15(6):549-52.

[Interpretation of the updated guidelines for prevention of surgical site infection].

[Article in Chinese]

Fan CG¹.

Author information

• ¹Nanjing University School of Medicine, Nanjing, China. fancg2002@yahoo.com

Abstract

The Guideline for prevention of surgical site infection had been published by the Centers for Disease Control for over 10 years. The Updated Recommendations for Control of Surgical Site Infections was published based on large amount of research results; last year, which focused on reduction in contamination, reduction in consequences of contamination and improvement of host defense. This article aims to review these guidelines so that improve clinical practice and decrease the complication of surgical site infection

sas-schatzi

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0067167

Link will connect to full study.

Abstract

Background

Surgical site infections (SSI) are an important cause of peri-surgical morbidity with risks that vary extensively between patients and surgeries. Quantifying SSI risk would help identify candidates most likely to benefit from interventions to decrease the risk of SSI.

Methods

We randomly divided all surgeries recorded in the National Surgical Quality Improvement Program from 2010 into a derivation and validation population. We used multivariate logistic regression to determine the independent association of patient and surgical covariates with the risk of any SSI (including superficial, deep, and organ space SSI) within 30 days of surgery. To capture factors particular to specific surgeries, we developed a surgical risk score specific to all surgeries having a common first 3 numbers of their CPT code.

Results

Derivation (n = 181 894) and validation (n = 181 146) patients were similar for all demographics, past medical history, and surgical factors. Overall SSI risk was 3.9%. The SSI Risk Score (SSIRS) found that risk increased with patient factors (smoking, increased body mass index), certain comorbidities (peripheral vascular disease, metastatic cancer, chronic steroid use, recent sepsis), and operative characteristics (surgical urgency; increased ASA class; longer operation duration; infected wounds; general anaesthesia; performance of more than one procedure; and CPT score). In the validation population, the SSIRS had good discrimination (c-statistic 0.800, 95% CI 0.795–0.805) and calibration.

Conclusion

SSIRS can be calculated using patient and surgery information to estimate individual risk of SSI for a broad range of surgery types.