New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective

Benedetta Allegranzi; Peter Bischoff; Stijn de Jonge; N Zeynep Kubilay; Bassim Zayed; Stacey M Gomes; Mohamed Abbas; Jasper J Atema; Sarah Gans; Miranda van Rijen; Marja A Boermeester; Matthias Egger; Jan Kluytmans; Didier Pittet; Joseph S Solomkin; WHO Guidelines Development Group

doi:10.1016/S1473-3099(16)30398-X

New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective

Lancet Infect Dis. 2016 Dec;16(12):e276-e287. doi: 10.1016/S1473-3099(16)30398-X. Epub 2016 Nov 2.

Authors

Affiliations

¹ Infection Prevention and Control Global Unit, Service Delivery and Safety, WHO, Geneva, Switzerland. Electronic address: [email protected].
² Institute of Hygiene and Environmental Medicine, Charité-University Medicine, Berlin, Germany.
³ Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands.
⁴ Infection Prevention and Control Global Unit, Service Delivery and Safety, WHO, Geneva, Switzerland.
⁵ OASIS Global, Cincinnati, OH, USA.
⁶ Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
⁷ Amphia Hospital Breda, Breda, Netherlands.
⁸ Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
⁹ Amphia Hospital Breda, Breda, Netherlands; University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands.
¹⁰ Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; WHO Collaborating Centre on Patient Safety (Infection Control and Improving Practices), University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
¹¹ OASIS Global, Cincinnati, OH, USA; Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

PMID: 27816413
DOI: 10.1016/S1473-3099(16)30398-X

Abstract

Surgical site infections (SSIs) are among the most preventable health-care-associated infections and are a substantial burden to health-care systems and service payers worldwide in terms of patient morbidity, mortality, and additional costs. SSI prevention is complex and requires the integration of a range of measures before, during, and after surgery. No international guidelines are available and inconsistencies in the interpretation of evidence and recommendations of national guidelines have been identified. Given the burden of SSIs worldwide, the numerous gaps in evidence-based guidance, and the need for standardisation and a global approach, WHO decided to prioritise the development of evidence-based recommendations for the prevention of SSIs. The guidelines take into account the balance between benefits and harms, the evidence quality, cost and resource use implications, and patient values and preferences. On the basis of systematic literature reviews and expert consensus, we present 13 recommendations on preoperative preventive measures.

MeSH terms

Consensus
Evidence-Based Medicine*
Global Health
Humans
Infection Control / methods
Infection Control / standards
Practice Guidelines as Topic*
Preoperative Care*
Risk Factors
Surgical Wound Infection / economics
Surgical Wound Infection / prevention & control*
World Health Organization*