Preoperative Interventions for the Prevention of Surgical Site Infections: A Review of Guidelines

Key Message

Six evidence-based guidelines regarding the use of preoperative interventions for the prevention of surgical site infections were included in this report. Four included guidelines were of high quality, while two guidelines were of moderate quality due to unclear reporting of methodological details.Of these guidelines, for the purpose of infection prevention, four recommend nasal decolonization with mupirocin, body washing with chlorhexidine gluconate, and bathing with antimicrobial or non-antimicrobial soap prior to surgery. Furthermore, four guidelines recommend the use of alcohol-based solutions for skin antiseptic preparation but recommend against hair removal unless absolutely required. Three guidelines recommend mechanical bowel preparation with oral antibiotics for elective colorectal surgery, while one guideline recommends against its use with no mention of specific indications or concurrent antibiotic use. Two guidelines made recommendations on perioperative blood glucose control with different target levels. Four guidelines made recommendations on the optimal time for administering antibiotic prophylaxis (i.e., at one or two hours before incision, or at the time of anesthesia). Overall, these recommendations ranged from conditional to strong and were based on evidence that ranged in quality from very low to high (when reported).