Publication of new NICE guidelines frequently generate discussion, so
as a surgical team we read and debated with interest the recent article
summarising NICE guidelines in the prevention and treatment of surgical
site infection (1). Among many recommendations the article advised ‘Do not
use diathermy for surgical incision to reduce the risk of surgical site
infection.’ This statement appeared to suggest we should change our
practice and stop using the finger-switch diathermy.
We are keen to follow evidence based guidelines so we referred back
to the source (the published NICE guidelines) where the situation became
clear – there was no evidence that either carried a higher risk of wound
infection, but this advice seemed lost in translation. Now we understand
this guidance, we urge others to look at the data from the source, debate,
discuss and share this information, and reach for either your knife or
diathermy without apprehension.
Neil Smith MA (Oxon), MBBS FRCS (Gen Surg.) Consultant General
Surgeon
General Surgical Department
East Surrey Hospital, Surrey & Sussex Healthcare NHS Trust.
1.Prevention and treatment of surgical site infection: summary of
NICE guidance.
Leaper D, Burman-Roy S, Palanca A, Cullen K, Worster D, Gautam-Aitken E,
Whittle M; Guideline Development Group.
BMJ. 2008 Oct 28;337:a1924.
Rapid Response:
Lost in Translation
Publication of new NICE guidelines frequently generate discussion, so
as a surgical team we read and debated with interest the recent article
summarising NICE guidelines in the prevention and treatment of surgical
site infection (1). Among many recommendations the article advised ‘Do not
use diathermy for surgical incision to reduce the risk of surgical site
infection.’ This statement appeared to suggest we should change our
practice and stop using the finger-switch diathermy.
We are keen to follow evidence based guidelines so we referred back
to the source (the published NICE guidelines) where the situation became
clear – there was no evidence that either carried a higher risk of wound
infection, but this advice seemed lost in translation. Now we understand
this guidance, we urge others to look at the data from the source, debate,
discuss and share this information, and reach for either your knife or
diathermy without apprehension.
Elizabeth Clayton MBBS, BMed. Sci, MRCS (Eng), MSc (Dist.)
Specialist Registrar
Caroline George MBBS BSc Foundation Year 1 Doctor
Neil Smith MA (Oxon), MBBS FRCS (Gen Surg.) Consultant General
Surgeon
General Surgical Department
East Surrey Hospital, Surrey & Sussex Healthcare NHS Trust.
1.Prevention and treatment of surgical site infection: summary of
NICE guidance.
Leaper D, Burman-Roy S, Palanca A, Cullen K, Worster D, Gautam-Aitken E,
Whittle M; Guideline Development Group.
BMJ. 2008 Oct 28;337:a1924.
Competing interests:
None declared
Competing interests: No competing interests