This guideline covers preventing and treating surgical site infections in adults, young people and children who are having a surgical procedure involving a cut through the skin. It focuses on methods used before, during and after surgery to minimise the risk of infection.
In August 2020, we added links to the NICE guideline on perioperative care in adults for additional recommendations on intravenous fluids, cardiac monitoring and blood glucose control in adults.
This guideline includes new and updated recommendations on:
- nasal decolonisation before surgery
- antiseptic skin preparation during surgery
- antiseptics and antibiotics before wound closure
- methods of wound closure
It also includes recommendations on:
- information for patients and carers
- what happens before surgery
- what happens during surgery
- what happens after surgery
- treating surgical site infection and specialist wound care services
Who is it for?
- Healthcare professionals
- Commissioners and providers
- People having surgery, their families and carers
Is this guideline up to date?
During the consultation period for this guideline, stakeholders raised the use of preoperative prophylactic antibiotics plus mechanical bowel preparation, to reduce surgical site infections in adults undergoing elective colorectal surgery. As this was outside the scope for this update, we completed an exceptional review in April 2019 and decided a further update was needed. See the review decision.
Guideline development process
This guideline updates and replaces NICE guideline CG74 (2008).
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.