A Loyola Medicine surgeon is first author of new guidelines for the prevention, detection and management of surgical site infections, which affect as many as 300,000 patients per year in the United States.
The guidelines detail the latest evidence for the measures that patients, surgeons and hospitals can do to prevent infections, such as quitting smoking (recommended), shaving the surgical site (not recommended, unless hair interferes with surgery) and showering after surgery (does not increase risk of infections).
The guidelines, published in the Journal of the American College of Surgeons, are an update of previously published guidelines. First author is Kristen A. Ban, MD, a resident in the department of surgery of Loyola University Medical Center. Corresponding author is Therese M. Duane, MD, of the John Peter Smith Health Network in Fort Worth, Texas.
Surgical site infections (SSIs) include infections in the area of the skin where the incision is made, infections below the incision in muscles and tissues surrounding muscles and infections in other parts of the body involved in the surgery.
SSIs are the most common and costly of all hospital-acquired infections, accounting for 20 percent of all hospital-acquired infections. They occur in an estimated 2 percent to 5 percent of patients undergoing inpatient surgery. The estimated annual incidence of SSIs in the U.S. ranges from 160,000 to 300,000, and the estimated annual cost ranges from $3.5 billion to $10 billion. On average, a surgical site infection increases the hospital length of stay by 9.7 days, according to studies cited in the guidelines.
These are among the guidelines' recommendations:
These are the main areas in which there is new evidence to support new or different guidelines:
There still are areas of controversy, including surgical attire, in which there are not enough high-quality data to support guidelines.
"Guidelines serve as a starting point for the delivery of evidence-based care, but they are only useful if they are implemented successfully," Dr. Ban and colleagues wrote in their article detailing the guidelines. "Hospitals must engage individuals at all levels, from front-line providers to leadership."
Materials provided by Loyola University Health System. Note: Content may be edited for style and length.
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