WHO updates SSI prevention guidelines: 29 ways to prevent infections

The World Health Organization released a list Thursday of 29 concrete recommendations to prevent surgical site infections, published in The Lancet Infectious Diseases.

"Preventing surgical site infections has never been more important but it is complex and requires a range of preventive measures," said Dr. Marie-Paule Kieny, WHO's assistant director-general for health systems and innovation. "These guidelines are an invaluable tool for protecting patients."

Of the 29 total recommendations to prevent SSIs, 13 are for preoperative preparation and 16 are for intraoperative and postoperative periods. The recommendations are valid in any country and should be used to complement the WHO's Surgical Safety Checklist. The recommendations were distilled by 20 leading experts from 26 reviews of the latest evidence available.

Some of the major recommendations include:

  • Do not use antimicrobial sealants after surgical skin preparation
  • Do not remove patients' hair unless it's absolutely necessary, and if it is, removal should be done only with a clipper. "Shaving is strongly discouraged at all times," the recommendations read.
  • Have patients bathe or shower with either plain soap or antimicrobial soap prior to surgery
  • Use warming devices in the operating room and during the procedure
  • Do not use antibiotic incisional wound irrigation before closure
  • Use antibiotics before and during surgery only — they should not be used after surgery

"By applying these new guidelines, surgical teams can reduce harm, improve quality of life, and do their bit to stop the spread of antibiotic resistance," said Ed Kelley, MD, PhD, director of the WHO's Department of Service Delivery and Safety.

See the full list of preoperative recommendations here. The full list of intraoperative and postoperative recommendations can be found here.

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