Table 1.
Summary of Recommendations from National and International Clinical Practice Guidelines
| Preventive measure | NICEa [9,10] (2008, 2017) | Spanish [11] 2010 | Canadian [12] 2014 | Anderson [13] | Scotland [14] 2015 | Allegranzi [7] (WHO)c 2016 | Berrios-Torres [8] (CDC)d 2017 |
|---|---|---|---|---|---|---|---|
| Hair removal | Do not | Do not | Do not | Do not | Do not | Do not | Do not |
| (if YES: clipping) | (if YES: clipping) | (if YES: clipping) | (if YES: clipping) | (if YES: clipping) | (if YES: clipping) | (if YES: clipping) | |
| Oral antibiotic prophylaxis | Yes | ||||||
| Mechanical bowel preparation | Do not | Do not | Yes | ||||
| Antiseptic skin preparation | Aqueous or alcohol-based PI or CHG | PI or CHG | Alcohol CHG > PI | Alcohol PI or CHG | Alcohol CHG > PI | Alcohol CHG | Alcohol |
| Plastic incise drapes | Do not (if YES: iodophor-impregnated) | Do not | Do not | Do not | Do not | ||
| Surgical site edge protection | Yes, plastic (dual>single) | Yes | |||||
| Normothermy | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Oxygenation | Yes (maintain O2 sat >95 %) | “Sufficient perfusion” | Yes Supplemental O2 | Yes (maintain O2 sat >95 %) | Yes Supplemental O2 | Unresolved | |
| Surgical site irrigation | Do not | Do not | Unresolved | Yes (PI solution) | |||
| Antimicrobial suture | Do not | Do not | Yes | Yes | |||
| Negative pressure surgical site therapy | Yes (high risk) |
Blank: No recommendation issued.
a
NICE = National Institute for Health and Care Excellence.
b
SHEA/IDSA = Society for Healthcare Epidemiology of America/Infectious Diseases Society of America.
c
WHO = World Health Organization.
d
CDC = Centers for Disease Control and Prevention.
Different systems of evidence quality gradation are used. These recommendations are also supported by different levels of evidence. Modified from Badia JM et al.[6]
PI = povidone iodine; CHG = chlorhexidine gluconate.