CDC issues new prevention guidelines for surgical site infections: 5 things to know

The CDC published its long-awaited update on recommendations for the prevention of surgical site infections on Wednesday in JAMA Surgery.

The new guidance supplants the agency's previous SSI prevention guidelines issued in 1999.

Here are five things to know about the new guidelines.

1. The CDC's Sandra Berríos-Torres, MD, served as the lead author of the guidelines.

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2. Researchers conducted a review of more than 5,000 studies published from 1998 through 2014. Among these studies, 896 underwent full-text review. Of the 896 studies, 170 studies were named eligible and were fully analyzed.

3. The research team separated recommendations into categories based on the quality of the evidence supporting the advisory. The categories include 1A, strong recommendation supported by high to moderate–quality evidence; 1B, strong recommendation supported by low-quality evidence; 1C, strong recommendation required by state of federal regulation; category II, a weak recommendation supported by marginal evidence which would likely result in the clinical benefits and harms; and no recommendation signaling an unresolved issue.

4. New recommendations include, but are not limited to:

• Advising patients to complete a full-body shower the night before surgery
• Administering antimicrobial prophylaxis prior to incision during cesarean delivery
• Applying an alcohol-based agent to the skin prior to surgery in most cases
• Forgoing the use of plastic adhesive drapes as they are unnecessary for SSI prevention
• Refraining from the application topical antimicrobial agents to the incision
• Not withholding blood transfusions as an SSI prevention method

5. In an invited commentary discussing the guidelines also published in JAMA Surgery, Pamela Lipsett, MD, a professor for surgery at Johns Hopkins Medicine in Baltimore, wrote the new guidelines are useful to every surgeon because it distinguishes between what surgeons should to do to prevent SSIs and what remains unknown about SSI prevention.

"How do guidelines help us in practice? When their development is rigorous, experts are used to systematically review the evidence and tell us what we can do (or not do) for most patients," wrote Dr. Lipset. "The guidelines by [Dr.] Berríos-Torres et al do exactly that, and they show us the way forward."

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