🛡️ Intraoperative Surgical Site Infection (SSI) Prevention

The intraoperative period is critical for maintaining sterility and minimizing the risk of surgical site infections (SSIs). Strict adherence to infection prevention measures ensures better outcomes.

• Maintain a sterile field throughout the procedure
• Prevent microbial contamination of surgical instruments and wounds
• Optimize patient and environmental factors intraoperatively

• Perform with chlorhexidine or povidone-iodine-based scrub
• Use alcohol-based hand rubs if preferred
• Include proper gowning and gloving

• Ensure adequate drying of antiseptic before draping
• Use sterile, fluid-impermeable drapes
• Re-prep site if contamination occurs

• Re-administer prophylactic antibiotics:
  1. After 2–4 hours (depending on agent)
  2. In case of major blood loss (>1500 mL)

• Limit door openings and personnel traffic
• Maintain positive-pressure ventilation
• Use HEPA-filtered airflow (especially for implants)

• Use sterile instruments and sterile fields
• Avoid reuse of instruments for deep vs superficial tissues
• Replace contaminated gloves/instruments immediately

• Avoid hematoma formation
• Minimize tissue trauma and devitalization
• Irrigate wound with sterile saline before closure

• Use antibiotic-coated implants when indicated
• Minimize exposure time of implants before placement
• Avoid contact with non-sterile surfaces

• Maintain CSF integrity (avoid leaks)
• Use antibiotic-impregnated catheters for EVD/shunts
• Avoid excessive dural manipulation or retraction
• Consider surgical field irrigation with vancomycin (case-dependent)

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