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Table 1 ACS-NSQIP Best Practice SSI Prevention Bundle

From: Prophylactic antibiotic bundle compliance and surgical site infections: an artificial neural network analysis

PreoperativeIntraoperativePostoperative
Patient-RelatedPatient-RelatedPatient-Related
Encourage patient to discontinue tobacco use for at least 30 days prior to operationMonitor and maintain glucose levels (< 200 mg/dl) in cardiothoracic surgery patients, including non-diabetic patientsMonitor and maintain glucose levels (< 200 mg/dl) in cardiothoracic surgery patients, including non-diabetic patients
Identify and treat all non-surgical site infections prior to surgery. Postpone elective operations if necessaryDiscontinue prophylactic antibiotics within 24 h after noncardiac surgery and 48 h after cardiac surgeryDiscontinue prophylactic antibiotics within 24 h after noncardiac surgery and 48 h after cardiac surgery
Administer prophylactic antibiotics within one hour prior to surgery (vancomycin and fluoroquinolones should be administered two hours prior to surgery). Select the appropriate antimicrobial prophylaxis based on evidence-based guidelinesCover primarily closed incisions with a sterile dressing for 24 to 48 h postoperatively. Wash hands before and after any contact with surgical site.Cover primarily closed incisions with a sterile dressing for 24 to 48 h
Adjust the dose of the prophylactic antibiotics for morbid obesity  
Provider-RelatedProvider-Related 
Keep nails short. Do not wear artificial nails or hand or arm jewelryWear a cap or hood to fully cover head/facial hair and a surgical mask to cover nose/mouth when entering the operating room (if operation is about to begin, is underway, or surgical instruments are exposed) and until the conclusion of the operation. 
Clean underneath fingernails prior to first daily surgical scrub. Complete a two to five minute preoperative scrub using appropriate antiseptic or use alcohol-based surgical antisepticUse surgical gown and drapes that are liquid resistant 
 Wear sterile gloves if a scrubbed surgical team member 
 Change surgical scrubs if grossly soiled or contaminate 
 System-Related 
 Comply with standards regarding operating room asepsis 
 When visible contamination of surfaces/equipment with body fluids occurs, use an Environmental Protection Agency-approved cleaning solution to clean affected area before next operation