Evidence-Based Update to the U.S. Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection: Developmental Process

Abstract

Recommendations in the "Guideline for Prevention of Surgical Site Infection, 1999" were based on experts' selective interpretation of the scientific evidence. Effective 2009, the U.S. Centers for Disease Control and Prevention (CDC) and its Healthcare Infection Control Practices Advisory Committee (HICPAC) updated their guideline development process. This is a narrative summary of the updated process focusing on key changes and challenges specific to the Guideline for Prevention of Surgical Site Infection. The guideline development process now incorporates evidence-based methodology and provides explicit links between the evidence and the recommendations using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. There is also participation by professional surgical societies, an updated guideline structure (core and procedure-specific sections), additional planned related manuscripts (introductions to the guideline and research opportunities), and new proposed venues for publication. The new CDC and HICPAC "Guideline for the Prevention of Surgical Site Infection" represents a substantial advancement from recommendations for infection control practices based on expert opinion to evidence-based practices. The new structure is meant to facilitate future updates, in particular, those addressing specialty or procedure-specific surgical site infection prevention questions. Increased presence by the surgical community through the professional surgical societies' engagement in the guideline development process, lead authorship of related manuscripts, and proposed publication in the surgical literature not only increase adherence by the surgical community, but also promote an ongoing collaboration with public health and other partners in a multidisciplinary approach to SSI prevention.

Infecção Em Cirurgia

“…-Infectadas: presença de pus, víscera oca perfurada e lesões traumáticas com mais de seis horas de evolução 12,13 . Ex: Cirurgia da diverticulite perfurada.…”

“…Ex: Cirurgia da diverticulite perfurada. ao ambulatório deve-se dar em torno do 15º ao 30° dia de pós-operatório 6,13 .…”

“…Com base nos fatores de risco, a CCIH deve atuar na prevenção e controle da infecção hospitalar nos seguintes campos de atuação: 13 1. Diagnóstico preciso dos casos de infecção.…”

“…Control (CDC), desde que a maioria das infecções pós-cirúrgicas são adquiridas na sala de operações, boa técnica é crucial para a sua prevenção e a maioria das medidas deve ser dirigida para influenciar adequadamente as equipes cirúrgicas 13 . Cirurgias com duração acima de três horas aumentam o risco de infecção de 3-4 vezes; que o uso excessivo do bisturi elétrico e a utilização de drenos laminares aumentam em duas vezes a infecção.…”

Prophylactic vacuum sealing drainage (VSD) in the prevention of postoperative surgical site infections in pediatric patients with contaminated laparotomy incisions

“…[7,8] Although there was clear evidence supporting prophylactic antibiotics, the effectiveness of other preventive techniques was not confirmed, such as preoperative skin antisepsis, intraoperative glove change, suction wound drainage, and different wound closure techniques. [9,10] …”