Practice Guidelines

Prevention and treatment of surgical site infection: summary of NICE guidance

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a1924 (Published 28 October 2008) Cite this as: BMJ 2008;337:a1924
  1. David Leaper, visiting professor1,
  2. Shona Burman-Roy, systematic reviewer 2,
  3. Ana Palanca, research assistant 2,
  4. Katherine Cullen, health economist2,
  5. Danielle Worster, information scientist 2,
  6. Eva Gautam-Aitken, project manager2,
  7. Martin Whittle, clinical codirector2
  8. On behalf of the Guideline Development Group
  1. 1Department of Wound Healing, Cardiff University, Cardiff
  2. 2National Collaborating Centre for Women’s and Children’s Health, London W1T 2QA
  1. Correspondence to: D Leaper, National Collaborating Centre for Women’s and Children’s Health, King’s Court, 2-16 Goodge Street, London W1T 2QA profdavidleaper{at}doctors.org.uk

    Why read this summary?

    The consequences of infection at the site of surgery can be devastating to the patient and costly to manage, often requiring readmission to hospital. Surgical site infections account for 14% of all healthcare acquired infections.1 This article summarises the most recent guidance from the National Institute for Health and Clinical Excellence (NICE) for the prevention and management of surgical site infection.2

    Recommendations

    NICE recommendations are based on systematic reviews of best available evidence. When minimal evidence is available, recommendations are based on the guideline development group’s opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets.

    Information for patients and carers

    Provide patients and carers with clear and consistent, easily understood information and advice throughout all stages of their care. Information should include:

    • The risks of surgical site infections, how to prevent them, and how they are managed using an integrated care pathway

    • How to recognise a surgical site infection and who to contact if they are concerned

    • How to care for their wound after discharge from hospital.

    • Whether they have been given antibiotics before or after an operation.

    [All these recommendations are based on a high quality randomised controlled trial and on the opinion of the Guideline Development Group]

    Preoperative phase

    Showering

    • Advise patients to shower or have a bath using soap (or help them with this) either the day before, or on the day of, surgery.

    Hair removal

    • Do not use hair removal routinely to reduce the risk of surgical site infection. [Based on a high quality systematic review of randomised controlled trials]

    • If hair removal is necessary, use electric clippers with a single-use head on the day of surgery rather than razors, which increase risk of surgical site infection. [Based on a high quality systematic review of randomised controlled trials and a cost-effectiveness …

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