The document discusses strategies for preventing surgical site infections (SSIs). It outlines evidence-based practices like having patients shower with soap or antiseptics before surgery, performing skin preparation in the operating room with alcohol-based agents, and considering intraoperative irrigation of tissues with aqueous iodophor solution. While some strategies are recommended, evidence on others is uncertain, such as optimal timing of preoperative bathing or use of antimicrobial sealants after surgery. The goal is to reduce the human and financial costs of SSIs using preventative methods that are proven to be effective.

1. Antiseptic Prophylaxis
in
SURGICAL SITE INFECTIONS
Dr.T.V.Rao MD
7/5/2017 Dr.T.V.Rao MD@ Surgical site infections 1

2. Our Vision to Reduce and
Control of Surgical Site
Infections
• Post-discharge surgical site infections (SSI)
are a major source of morbidity, expense
and anxiety for patients. However, Health
care professionals have a greater role to
understand the basic perceptions to prevent
and reduce the Surgical site infections
• Practice of Evidence based is the need of the
Hour
• Dr.T.V.Rao MD
• Freelance Clinical Microbiologist
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3. What are
Surgical Site
Infections
• Surgical site infections (SSIs)
are infections of the incision or
organ or space that occur after
surgery. Surgical patients
initially seen with more
complex comorbidities and the
emergence of antimicrobial-
resistant pathogens increase
the cost and challenge of
treating SSIs
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4. Surgical Infection can be
prevented better with
scientific approaches
•Surgical site infections are
persistent and preventable
health care–associated
infections. There is
increasing demand for
evidence-based
interventions for the
prevention of SSI.7/5/2017 Dr.T.V.Rao MD@ Surgical site infections 4

5. Consequences of Surgical Site Infections
•The human and financial costs of treating
surgical site infections (SSIs) are increasing. The
number of surgical procedures performed in the
United States continues to rise, and surgical
patients are initially seen with increasingly
complex comorbidities. It is estimated that
approximately half of SSIs are deemed
preventable using evidence-based strategies.7/5/2017 Dr.T.V.Rao MD@ Surgical site infections 5

6. Showring with Soap
and / or antiseptics
• Advise patients to shower
or bathe (full body) with
soap (antimicrobial or
nonantimicrobial) or an
antiseptic agent on at least
the night before the
operative day
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7. Best practices are still
un resolved in Bathing
• Randomized controlled trial evidence
suggested uncertain trade-offs between
the benefits and harms regarding the
optimal timing of the preoperative
shower or bath, the total number of
soap or antiseptic agent applications, or
the use of chlorhexidine gluconate
washcloths for the prevention of SSI.
(No recommendation/unresolved
issue.)
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8. Skin Preparation with Alcohol
•Skin preparation in the operating room should
be performed using an alcohol-based agent
unless contraindicated. For clean and clean-
contaminated procedures, additional
prophylactic antimicrobial agent doses should
not be administered after the surgical incision is
closed in the operating room, even in the
presence of a drain.
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9. Skin preparation
with Antiseptics
•Perform intraoperative
skin preparation with an
alcohol-based antiseptic
agent unless
contraindicated. (Category
IA–strong
recommendation; high-
quality evidence.
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10. Application of sealant
after Surgery
beneficial or not
• Application of a
microbial sealant
immediately after
intraoperative skin
preparation is not
necessary for the
prevention of Surgical
site infections .
• low-quality evidence
suggesting a trade-off
between clinical
benefits and harms
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11. Resist use of Topical Antimicrobials
•Topical
antimicrobial
agents should
not be applied
to the surgical
incision.7/5/2017 Dr.T.V.Rao MD@ Surgical site infections 11

12. Plastic Drapes
are not
recommended
• The use of plastic
adhesive drapes with or
without antimicrobial
properties is not
necessary for the
prevention of SSI
• weak recommendation;
high to moderate–
quality evidence
suggesting a trade-off
between clinical
benefits and harms
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13. Intraoperative
irrigation of deep or
subcutaneous tissues
• Consider intraoperative irrigation of
deep or subcutaneous tissues with
aqueous iodophor solution for the
prevention of SSI. Intraperitoneal
lavage with aqueous iodophor solution
in contaminated or dirty abdominal
procedures is not necessary.
(Category II–weak recommendation
moderate-quality evidence suggesting
a trade-off between clinical benefits
and harms7/5/2017 Dr.T.V.Rao MD@ Surgical site infections 13

14. Soaking
Prosthetic devices
in Antiseptic
solution
• The search did not identify
randomized controlled trials
that evaluated soaking
prosthetic devices in
antiseptic solutions before
implantation for the
prevention of SSI.
(No
recommendation/unresolve
d issue.)
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15. Need for Application of
Antiseptic solutions to
wound site
• Randomized controlled trial
evidence was insufficient to
evaluate the trade-offs
between the benefits and
harms of repeat application of
antiseptic agents to the
patient’s skin immediately
before closing the surgical
incision for the prevention of
SSI.
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16. Surgical site
Infections can be
prevented by evidence
based strategies
•It has been estimated
that approximately
half of SSIs are
preventable by
application of
evidence-based
strategies.
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17. Patient Concerns to be Addressed by Medical
Professionals
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18. 7/5/2017 Dr.T.V.Rao MD@ Surgical site infections 18

19. United we
work can
make a
great
progress in
reducing
Hospital
associated
Infections
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20. 7/5/2017 Dr.T.V.Rao MD@ Surgical site infections 20

21. References
•Article Information Trends of Surgical site Infections
•Corresponding Author: Erin C. Stone, MA, Division of
Healthcare Quality Promotion, Centers for Disease
Control and Prevention, 1660 Clifton Rd NE, Mail Stop
A07 Atlanta, GA 30329 (ecstone@cdc.gov).
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22. •Program created by Dr.T.V.Rao MD for
benefit of Medical and Nursing Professionals
on Primary care to Prevent Surgical site
infections
•Email
•doctortvrao@gmail.com
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