Prevention of Surgical Site Infection in Abdominal Surgery. A Critical Review of the Evidence

Abstract

Surgical site infection (SSI) is associated with prolonged hospital stay, increased morbidity, mortality and sanitary costs, and reduced patients’ quality of life. Many hospitals have adopted guidelines of scientifically validated processes for prevention of surgical site and central-line catheter infections and sepsis. Most of these guidelines have resulted in an improvement in postoperative results. A review of the best available evidence on these measures in abdominal surgery is presented. The best measures are: avoidance of hair removal from the surgical field, skin decontamination with alcoholic antiseptic, correct use of antibiotic prophylaxis (administration within 30–60min before incision, use of 1st or 2nd generation cephalosporins, single preoperative dose, dosage adjustments based on body weight and renal function, intraoperative re-dosing if the duration of the procedure exceeds 2 half-lives of the drug or there is excessive blood loss), prevention of hypothermia, control of perioperative glucose levels, avoidance of blood transfusion and restriction of intraoperative liquid infusion.