Friday, June 15, 2018

For the first time since 1999, the CDC makes new recommendations for the prevention of surgical related infections...

CDC used thousands of studies to the relevant situation such as prevention in SSI surgical site infections, they narrowed it down to a mere 170 studies in order to issue these final recommendations, the first of any recommendations since 1999.  Remeber that the CDC states that most of the recommendations that were made back in 1999, these recommendations were made based on expert opinion rather than evidenced-based recommendations.

So these new recommendations are evidenced-based recommendations and should be taken very seriously.  These recommendations are:

-Patients should shower or bathe (full body) with soap (antimicrobial or nonantimicrobial) or an antiseptic agent on at least the night before surgery.

-Antimicrobial prophylaxis should be administered only when indicated and timed such that a bactericidal concentration of the agents is established in the serum and tissues when the incision is made.

-Skin prep in the OR should be done with an alcohol-based agent unless contraindicated.

-Clean and clean-contaminated procedures, additional prophylactic antimicrobial agent doses should not be administered after the surgical incision is closed in the OR, even when a drain is being used.

-Topical antimicrobial agents should not be applied to the surgical incision.

-During surgery, glycemic control should be implemented using blood glucose target levels less than 200 mg/dL.

-Normothermia should be maintained in all patients.

-For patients with normal pulmonary function undergoing general anesthesia with endotracheal intubation, an increased fraction of inspired oxygen should be administered during surgery and immediately after extubation in post-op.

-Blood transfusions should not be withheld from surgical patients as a means to prevent SSIs.

Which ones of these will you be making your surgery center compliant too?  For the better quality outcomes for all surgical patients, these techniques should be adopted immediately and invited across the continuum of care of the entire US region of the world. 

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