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Table 2 Summary of intraoperative interventions

From: Current preventive measures for health-care associated surgical site infections: a review

Intraoperative interventions

Summary

References

Prophylactic antibiotics

• Prophylactic antibiotics are effective in reducing SSI rates

[57]-[62]

• Discontinue within 24 hours of closure to prevent superinfection

• Redosing may be beneficial for procedures > 4 hours or if EBL > 1.5 L

• Timing, duration, selection of antibiotics should be incorporated into the "time-out" to improve compliance

Skin preparation

• No clear evidence that one preparation solution is superior

[63]-[66]

Wound irrigation

• Important to remove loose, necrotic tissue, debris, and microorganisms from surgical site

[67]-[69]

• No difference in infection rates between saline and tap water

• Dilute betadine solution may be of benefit

Thermoregulation

• Maintaining perioperative normothermia may reduce SSI rates

[70],[71]

Antiseptic-coated sutures

• Effective in reducing SSI rates in neurosurgical patients, but cost-effectiveness has yet to be determined

[72],[73]

Operating room traffic

• Limit OR traffic flow

[74]