🛡️ Preoperative Surgical Site Infection (SSI) Prevention

Surgical site infections (SSIs) are among the most common healthcare-associated infections and can significantly impact patient outcomes. A structured preoperative prevention strategy is essential to reduce SSI risk.

• Minimize bacterial load at and around the surgical site
• Optimize patient factors that influence immune response
• Ensure aseptic conditions during the entire perioperative period

• Preoperative bathing with antiseptic agents (e.g., chlorhexidine) the night before and morning of surgery
• Emphasize attention to areas near the incision site

• Only if necessary
• Use clippers (not razors)
• Perform immediately before surgery

• Administer appropriate antibiotic within 60 minutes before incision
• Selection based on:
  1. Type of procedure
  2. Local antibiogram
  3. Patient allergies
• Re-dose if surgery exceeds 2–4 hours or in cases of major blood loss

• Apply alcohol-based antiseptic (e.g., CHG-alcohol) unless contraindicated
• Allow sufficient drying time
• Avoid contamination after application

• Optimize glucose control (target blood glucose <180 mg/dL)
• Treat remote infections prior to elective surgery
• Address anemia, malnutrition, smoking, or obesity preoperatively
• Screen for Staphylococcus aureus nasal carriage (select cases)

• Maintain air quality (e.g., laminar airflow for implants)
• Minimize traffic and door openings
• Ensure availability of sterile equipment and drapes

• Instruction on pre-op hygiene, fasting, and medication management
• Reinforce not to shave at home
• Inform about SSI symptoms and postoperative care

• High-risk procedures (e.g., craniotomy, spinal instrumentation)
• Consider antibiotic-impregnated materials (e.g., EVD, shunts)
• Avoid CSF leak and ensure watertight dural closure