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  • In April 2019 this guideline was updated. The evidence on nasal decolonisation, preoperative antiseptic skin preparation, antiseptics and antimicrobials before wound closure, and methods of wound closure was reviewed. Some of the 2008 recommendations have been retained in the new guideline. This 2008 full guideline includes the evidence supporting the 2008 recommendations. The PDF has been colour-coded as follows: All text without shading is from the original 2008 guideline and has not been amended by subsequent updates; Black shading indicates text from 2008 has been replaced by the 2019 update.

In April 2019 this guideline was updated. The evidence on nasal decolonisation, preoperative antiseptic skin preparation, antiseptics and antimicrobials before wound closure, and methods of wound closure was reviewed. Some of the 2008 recommendations have been retained in the new guideline. This 2008 full guideline includes the evidence supporting the 2008 recommendations. The PDF has been colour-coded as follows: All text without shading is from the original 2008 guideline and has not been amended by subsequent updates; Black shading indicates text from 2008 has been replaced by the 2019 update.

Cover of Surgical Site Infection

Surgical Site Infection

Prevention and Treatment of Surgical Site Infection

NICE Clinical Guidelines, No. 74

.

London: RCOG Press; .
ISBN-13: 978-1-904752-69-1

Excerpt

In April 2019 this guideline was updated.

Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital.

SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing.

SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between £814 and £6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.

Contents

While every effort has been made to ensure the accuracy of the information contained within this publication, the publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check current indications and accuracy by consulting other pharmaceutical literature and following the guidelines laid down by the manufacturers of specific products and the relevant authorities in the country in which they are practising.

Copyright © 2008, National Collaborating Centre for Women’s and Children’s Health.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK [www.cla.co.uk]. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

Bookshelf ID: NBK53731PMID: 21698848

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