An Overview of Surgical Site Infection in Low- and Middle-Income Countries: the Role of Recent Guidelines, Limitations, and Possible Solutions

Abstract

The purpose of this manuscript is to review preventive strategies for surgical site infection (SSI) in low- and middle-income countries (LMIC) and how the recent World Health Organization (WHO) guidelines, along with the Centers for Disease Control (CDC) recommendations on SSI prevention, may be implemented on these settings, considering frequent limitations and possible solutions. Surgical site infection (SSI) is the most common postoperative complication and in LMIC is the first cause among healthcare-associated infections (HAI). SSIs are largely preventable if there is a standardized process of care throughout the operative and perioperative period. SSIs, especially clean procedures, are considered a marker of quality in healthcare. Education and cultural aspects have an enormous influence on the correct performance of SSI preventive measures. Getting patients and healthcare professionals engaged with prevention is the first step to make policies work properly in LMIC, no matter how this might take a lot of time and effort to be accomplished. Infection control professionals are not a luxury in any setting and efforts to support HAI control should be a priority. Surveillance is one of the most important and difficult tasks in SSI prevention.