Guidelines for the prevention of surgical site infection: The surgical infection society of Thailand recommendations (executive summary)

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND | 2020. Surgical site infection (SSI) is a common and potentially preventable complication after surgery. Recently there have been several guidelines for preventing SSI published by a variety of organizations. To promote the prevention of incisional SSI, the Surgical Infection Society of Thailand (SIST) systematically reviewed current evidence on this subject from the most recent studies available, together with expert opinions on appropriate and suitable interventions in Thailand. The SIST Recommendations cover four phases for a total of 28 items. They include pre-admission with three items, pre-operation with six items, intra-operation with 15 items, and post-operation with four items. Of these recommendations, 10 items are Level 1 evidence or high level of evidence and are grouped into "Thailand's SSI Prevention Bundle". This care bundle includes smoking cessation, weight-based antibiotic prophylaxis, appropriate hair removal, skin preparation with alcohol-based solution, wound protectors for abdominal surgery, antimicrobial-coated sutures for clean operation in high-risk patients and elective digestive surgery, perioperative glucose control, intra-operative normothermia, peri-operative maintenance of oxygen saturation at least 92% or preferably at least 95%, and changing contaminated gloves and surgical instruments before wound closure. Intravenous antibiotic prophylaxis suitable for common operations in Thailand and their recommended dosing are noted in the SIST guidelines for the prevention of SSI.