Guideline for Prevention of Surgical Site Infection, 1999

Mangram, Alicia; Horan, Teresa C.; Pearson, Michele L.; Silver, Leah Christine; Jarvis, William R.

doi:10.1016/s0196-6553(99)70088-x

Cited by 2,617 publications

(1,353 citation statements)

References 384 publications

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“…A surgical‐site infection is by definition incisional (superficial or deep) or organ/space infection occurring within 30 days of surgery46. The risk is prolonged to 1 year if an implant is left in place46.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of negative-pressure wound therapy for closed surgical incisions

Hyldig

Birke-Sørensen

Kruse

et al. 2016

British Journal of Surgery

196

172

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BackgroundPostoperative wound complications are common following surgical procedures. Negative‐pressure wound therapy (NPWT) is well recognized for the management of open wounds and has been applied recently to closed surgical incisions. The evidence base to support this intervention is limited. The aim of this study was to assess whether NPWT reduces postoperative wound complications when applied to closed surgical incisions.MethodsThis was a systematic review and meta‐analysis of randomized clinical trials of NPWT compared with standard postoperative dressings on closed surgical incisions.ResultsTen studies met the inclusion criteria, reporting on 1311 incisions in 1089 patients. NPWT was associated with a significant reduction in wound infection (relative risk (RR) 0·54, 95 per cent c.i. 0·33 to 0·89) and seroma formation (RR 0·48, 0·27 to 0·84) compared with standard care. The reduction in wound dehiscence was not significant. The numbers needed to treat were three (seroma), 17 (dehiscence) and 25 (infection). Methodological heterogeneity across studies led to downgrading of the quality of evidence to moderate for infection and seroma, and low for dehiscence.ConclusionCompared with standard postoperative dressings, NPWT significantly reduced the rate of wound infection and seroma when applied to closed surgical wounds. Heterogeneity between the included studies means that no general recommendations can be made yet.

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Section: Discussionmentioning

confidence: 99%

Meta-analysis of negative-pressure wound therapy for closed surgical incisions

Hyldig

Birke-Sørensen

Kruse

et al. 2016

British Journal of Surgery

196

172

View full text Add to dashboard Cite

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“…17 The Centres for Disease Control and Prevention (CDC) in the USA recommends routine surveillance for surgical site infections as standard practice. 18 Surveillance not only helps to identify clusters of infection and risk factors, it also provides for comparison between institutions and surgical specialties. 19 An effective surveillance program must adjust infection rates for length of stay, as it is widely accepted that longer stays in hospital increase the likelihood of infection.…”

Section: Surveillance Of Infectionmentioning

confidence: 99%

“…20 Information pertaining to patient co-morbidities and antibiotic therapy have a substantial impact on infection rates and must therefore be taken into account when planning surveillance programs. [18][19][20][21] The process of undertaking a surveillance project forms only the initial part of a complete clinical audit.…”

Section: Surveillance Of Infectionmentioning

confidence: 99%

Postoperative infection rates in foot and ankle surgery: a clinical audit of Australian podiatric surgeons, January to December 2007

Butterworth

Gilheany²,

Tinley

2010

Aust. Health Review

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Background. Surgical site infections are one of the most common post-operative complications encountered by foot and ankle surgeons. The incidence reported in the literature varies between 0.5 and 6.5%. The results of a 12-month Australia-wide clinical audit analysing the rates of postoperative infections in association with podiatric surgery are presented.Methods. De-identified patient data was collected from nine podiatric surgeons Australia-wide. Infections were identified according to Australian Council on Health Care Standards (ACHS) definitions and data was entered no earlier than thirty days post procedure.Results. A total of 1339 patient admissions and 2387 surgical procedures were reported using the International Classification of Diseases (ICD-10) and Medicare Benefit Schedule (MBS) coding systems. The overall infection rate was 3.1% and the rate of infection resulting in hospital re-admission was 0.25%.Conclusions. The benchmark results presented in this paper suggest that infection rates associated with podiatric surgery are well within accepted industry standards as stated in recent literature.

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“…In addition, the stress response to surgical insult results in insulin tolerance, and decreased pancreatic beta‐cell function causes hypo‐insulinemia, augmenting stress‐induced hyperglycemia 2. For the prevention of surgical site infections (SSI), appropriate perioperative insulin therapy is required in patients with hyperglycemia 3, 4, 5, 6, 7…”

Section: Introductionmentioning

confidence: 99%

“…Earlier guidelines for prevention of SSI from the Centers for Disease Prevention and Control (CDC)3 published in 1999 recommended perioperative treatment of hyperglycemia (≥200 mg/dL) in patients with DM. The Surgical Care Improvement Project5 (SCIP) developed a quality performance measure to maintain the 6 a.m. controlled blood glucose level (BG) at <200 mg/dL in cardiac surgery (<180 mg/dL in the updated version11).…”

Section: Introductionmentioning

confidence: 99%

Strict glycemic control to prevent surgical site infections in gastroenterological surgery

Takesue

Tsuchida

2017

Annals of Gastroent Surgery

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Perioperative hyperglycemia is a risk factor for surgical site infections (SSI). Although the recommended target blood glucose level (BG) is 140–180 mg/dL for critically ill patients, recent studies conducted in patients undergoing surgery showed a significant benefit of intensive insulin therapy for the management of perioperative hyperglycemia. The aim of the present review is to evaluate the benefits of strict glycemic control for reducing SSI in gastroenterological surgery. We carried out a post‐hoc analysis of the previously published data from research on the risk factors for SSI. The highest BG within 24 hours after surgery was evaluated. A total of 1555 patients were enrolled in the study. In multivariate analysis, a dose–response relationship between the level of hyperglycemia and the odds of SSI was demonstrated when compared with the reference group (≤150 mg/dL) (odds ratio [OR] = 1.68, 95% confidence interval [CI] 1.14–2.49 for 150–200 mg/dL; and OR = 2.15, 95% CI 1.40–3.29 for >200 mg/dL). Unexpectedly, hyperglycemia was not a significant risk factor for SSI among diabetes patients. By contrast, non‐diabetes patients with a BG of >150 mg/dL were found to have increased odds of SSI. In conclusion, a target BG of ≤150 mg/dL is recommended in patients without diabetes who undergo gastroenterological surgery. Additional study is required to determine an optimal target BG in diabetes patients. Because of the risk of hypoglycemia, a conventional protocol is indicated for patients admitted to the general ward where frequent glucose measurement is not assured.

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Guideline for Prevention of Surgical Site Infection, 1999

Cited by 2,617 publications

References 384 publications

Meta-analysis of negative-pressure wound therapy for closed surgical incisions

Meta-analysis of negative-pressure wound therapy for closed surgical incisions

Postoperative infection rates in foot and ankle surgery: a clinical audit of Australian podiatric surgeons, January to December 2007

Strict glycemic control to prevent surgical site infections in gastroenterological surgery

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