CDC Updates Guideline for Prevention of Surgical Site Infection

The last version of the CDC guideline was published in 1999.

With modern medicine improving dramatically, people are living longer and surgeries are at an all-time high. With surgical practices ever-changing and evolving, providers in all surgical settings, including ambulatory surgery centers, office-based surgery practices, hospitals and their outpatient departments, must follow federal requirements for safe practices, including surgical site infection (SSI) prevention.

Infection preventionists, clinicians, accreditation organizations and the Centers for Medicare & Medicaid Services (CMS) rely heavily on the Centers for Disease Control and Prevention (CDC) to provide evidence-based guidelines for many areas of patient practice. Developing guidelines is a momentous task, often taking many years to gather evidence through analysis of numerous studies and painstaking examination of data. Following a systematic literature review of more than 5,000 studies published from 1998 through April 2014, CDC has issued updated evidence-based recommendations for preventing SSIs in the JAMA Surgery journal. This supersedes the last version of the CDC Guideline for Prevention of Surgical Site Infection published in 1999.

Updated recommendations include the following:

  • Patients should shower or bathe with soap or an antiseptic agent on at least the night before the day of surgery.
  • For cesarean sections, antimicrobial prophylaxis should be administered before skin incision.
  • OR skin prep should be performed using an alcohol-based agent (unless contraindicated).
  • Topical antimicrobial agents should not be applied to surgical incisions.
  • Normothermia should be maintained in all patients.
  • Blood glucose levels should be held under 200 mg/dL throughout a procedure.
  • Transfused blood products should not be withheld from patients to prevent SSI.

CDC obtains guidance primarily from the Healthcare Infection Control Practices Advisory Committee (HICPAC), a federal advisory committee chartered to provide advice and guidance to CDC regarding the practice of infection control and strategies for surveillance, prevention and control of healthcare-associated infections and antimicrobial resistance.

Healthcare personnel working in the surgical arena should closely review these guidelines to ensure their practices are updated and in alignment with quality improvement.

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