WHO Guidelines to Prevent Surgical Site Infection (SSI) – An Overview

Surgical Site InfectionThe World Health Organization (WHO) recently released new guidance on preventing surgical site infections (SSIs). Surgical site infections are caused by bacteria that get in through incisions made during a surgery. These infections are a threat to the lives of millions of patients each year and contribute to the spread of antibiotic resistance. Surgical wounds can be clean, clean-contaminated, contaminated or even dirty or infected. The new guidelines are valid for any country and suitable to local adaptations.

According to the WHO, surgical site infection (SSI) affects up to one third of patients who have undergone a surgical procedure. The prevention of such infections is complex and may require the integration of a range of preventive measures before, during and after surgery.

Certain WHO recommendations to reduce the risk of SSI include:

  • People preparing for surgery should always have a bath or shower but not be shaved
  • Antibiotics should only be used to prevent infections before and during surgery, not afterwards
  • For patients undergoing any surgical procedure, hair should either not be removed or, if absolutely necessary, be removed only with a clipper
  • Alcohol-based antiseptic solutions CHG (chlorhexidine gluconate) can be used for surgical site skin preparation
  • Antimicrobial sealants should not be used after surgical site skin preparation
  • Warming devices should be used in the OR and during the surgical procedure for patient body warming
  • Sterile, disposable non-woven or sterile, reusable woven drapes and gowns should be used during surgical operations
  • Antibiotic incisional wound irrigation should not be used
  • Prophylactic negative pressure wound therapy can be used in adult patients on primarily closed surgical incisions in high-risk wounds
  • Preoperative antibiotic prophylaxis should not be continued in the presence of a wound drain
  • Wound drain should be removed when clinically indicated

Regular Assessment and Documentation of SSI Play a Key Role

Regular assessment and documentation of SSI is essential to determine whether the condition is progressing through an orderly sequence of healing. Nurses must make sure to record all details including SSI signs and symptoms, impact of the wound on the patient’s daily life and body image, location and length of incision, closure methods used (sutures, staples, tape or tissue adhesives), presence of exudates and drains, and presence of an abscess or breakdown at the incision site. They should also maintain full documentation of all steps taken to prevent infections.

By using a wound EMR, nurses can document all wound details efficiently and accurately. Also, with such a reliable platform, surgeons can retrieve infection details faster, resulting in faster treatment. Digital photographs of infected areas can also be uploaded into the EMR so that diagnosis will be easier.