Key priorities for implementation

Key priorities for implementation

Information for patients and carers

  • Offer patients and carers clear, consistent information and advice throughout all stages of their care. This should include the risks of surgical site infections, what is being done to reduce them and how they are managed.

Preoperative phase

  • Do not use hair removal routinely to reduce the risk of surgical site infection.

  • If hair has to be removed, use electric clippers with a single-use head on the day of surgery. Do not use razors for hair removal, because they increase the risk of surgical site infection.

  • Give antibiotic prophylaxis to patients before:

    • clean surgery involving the placement of a prosthesis or implant

    • clean-contaminated surgery

    • contaminated surgery.

  • Do not use antibiotic prophylaxis routinely for clean non-prosthetic uncomplicated surgery.

  • Use the local antibiotic formulary and always consider potential adverse effects when choosing specific antibiotics for prophylaxis.

  • Consider giving a single dose of antibiotic prophylaxis intravenously on starting anaesthesia. However, give prophylaxis earlier for operations in which a tourniquet is used.

Intraoperative phase

  • Prepare the skin at the surgical site immediately before incision using an antiseptic (aqueous or alcohol-based) preparation: povidone‑iodine or chlorhexidine are most suitable.

  • Cover surgical incisions with an appropriate interactive dressing at the end of the operation.

Postoperative phase

  • Refer to a tissue viability nurse (or another healthcare professional with tissue viability expertise) for advice on appropriate dressings for the management of surgical wounds that are healing by secondary intention.

  • National Institute for Health and Care Excellence (NICE)