Guideline for Prevention of Surgical Site Infection, 1999☆,☆☆,★,★★
Section snippets
A. INTRODUCTION
Before the mid-19th century, surgical patients commonly developed postoperative “irritative fever,” followed by purulent drainage from their incisions, overwhelming sepsis, and often death. It was not until the late 1860s, after Joseph Lister introduced the principles of antisepsis, that postoperative infectious morbidity decreased substantially. Lister’s work radically changed surgery from an activity associated with infection and death to a discipline that could eliminate suffering and
A. RATIONALE
The Guideline for Prevention of Surgical Site Infection, 1999, provides recommendations concerning reduction of surgical site infection risk. Each recommendation is categorized on the basis of existing scientific data, theoretical rationale, and applicability. However, the previous CDC system for categorizing recommendations has been modified slightly.
Category I recommendations, including IA and IB, are those recommendations that are viewed as effective by HICPAC and experts in the fields of
Acknowledgements
The Hospital Infection Control Practices Committee thanks the following subject-matter experts for reviewing a preliminary draft of this guideline: Carol Applegeet, RN, MSN, CNOR, CNAA, FAAN; Ona Baker, RN, MSHA; Philip Barie, MD, FACS; Arnold Berry, MD; Col. Nancy Bjerke, BSN, MPH, CIC; John Bohnen, MD, FRCSC, FACS; Robert Condon, MS, MD, FACS; E. Patchen Dellinger, MD, FACS; Terrie Lee, RN, MS, MPH, CIC; Judith Mathias, RN; Anne Matlow, MD, MS, FRCPC; C. Glen Mayhall, MD; Rita McCormick, RN,
References (518)
The CDC Hospital Infection Control Practices Advisory Committee
Am J Infect Control
(1993)Creating greater efficiency in ambulatory surgery
J Clin Anesth
(1995)- et al.
Laparoscopic versus open appendectomy: a metaanalysis
J Am Coll Surg
(1998) - et al.
Serious wound infections after minimally invasive coronary bypass procedures
Ann Thorac Surg
(1998) - et al.
The epidemiology of wound infection: a 10-year prospective study of 62,939 wounds
Surg Clin North Am
(1980) - et al.
Effect of surgeon’s diagnosis on surgical wound infection rates
Am J Infect Control
(1990) Resistant gram-positive organisms
Ann Emerg Med
(1994)- et al.
Wound infection with Pseudomonas multivorans: a water-borne contaminant of disinfectant solutions
Lancet
(1970) - et al.
Evolution of quantitative bacteriology in wound management
Am J Surg
(1975) - et al.
Microbial/host interactions in health and disease: who controls the cytokine network?
Immunopharmacology
(1996)
Experimental colonization of an expanded polytetrafluoroethylene vascular graft with Staphylococcus aureus: a quantitative and morphologic study
J Vasc Surg
Surgical considerations of endogenous infections—sources, types, and methods of control
Surg Clin North Am
A late sternal wound infection caused by hematogenous spread of bacteria
Chest
Risk factors for infectious complications after abdominal surgery for malignant disease
Am J Infect Control
Total joint replacement: a consideration for antimicrobial prophylaxis
Oral Surg Oral Med Oral Pathol
Multiple irrigation, debridement, and retention of components in infected total knee arthroplasty
J Arthroplasty
Pyogenic vertebral osteomyelitis and postsurgical disc space infections
Ortho Clin North Am
Epidemics of postoperative wound infections associated with hair carriers
Lancet
An appraisal of the role of surgical face masks
Am J Surg
A fifteen-year wound surveillance study after coronary artery bypass
Ann Thorac Surg
The relationship of cigarette smoking to impaired intraoral wound healing: a review of evidence and implications for patient care
J Oral Maxillofac Surg
Wound complications after modified radical mastectomy compared with tylectomy with axillary lymph node dissection
Am J Surg
Operative morbidity and risk factor assessment in melanoma patients undergoing inguinal lymph node dissection
Am J Surg
Risk factors for operative mortality and sternal wound infection in bilateral internal mammary artery grafting
J Thorac Cardiovasc Surg
Predictors of intraoperative bacterial contamination and postoperative infection in elective colorectal surgery
J Hosp Infect
Factors affecting the incidence of postoperative wound infection
J Hosp Infect
CDC guideline for prevention of surgical wound infections, 1985. Supercedes guideline for prevention of surgical wound infections published in 1982. (Originally published in 1995)
Revised. Infect Control
Guideline for prevention of surgical wound infections
Infect Control
Pediatric wound infections: a prospective multicenter study
Ann Surg
Risks of the minimal access approach for laparoscopic surgery: multivariate analysis of morbidity related to umbilical trocar insertion
World J Surg
Postoperative complications of laparoscopic-assisted colectomy
Surg Endosc
A prospective analysis of 1518 laparoscopic cholecystectomies
N Engl J Med
National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1997, issued May 1997
Am J Infect Control
Topical antimicrobial drug products for over-the-counter human use: tentative final monograph for health-care antiseptic drug products—proposed rule (21 CFR Parts 333 and 369)
Federal Register
Vital and Health Statistics, Detailed Diagnoses and Procedures,
An overview of nosocomial infections, including the role of the microbiology laboratory
Clin Microbiol Rev
Wound infection surveillance
Rev Infect Dis
Incidence and nature of endemic and epidemic nosocomial infections
Hospital reimbursement patterns among patients with surgical wound infections following open heart surgery
Infect Control Hosp Epidemiol
Estimated costs of postoperative wound infections. A case-control study of marginal hospital and social security costs
Epidemiol Infect
Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization
Eur J Epidemiol
Cost effectiveness of preventive antibiotic administration for lowering risk of infection by 0.25%
Unfallchirurg
CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections
Infect Control Hosp Epidemiol
An apparent excess of operative site infections: analyses to evaluate false-positive diagnoses
Infect Control Hosp Epidemiol
Consensus paper on the surveillance of surgical wound infections
Infect Control Hosp Epidemiol
Prospective randomised comparison of single-dose versus multiple-dose cefuroxime for prophylaxis in coronary artery bypass grafting
Eur J Clin Microbiol Infect Dis
National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1996, issued May 1996. A report from the National Nosocomial Infections Surveillance (NNIS) System
Am J Infect Control
Major trends in the microbial etiology of nosocomial infection
Am J Med
Epidemiology of nosocomial fungal infections, with emphasis on Candida species
Clin Infect Dis
Nosocomial outbreak of Rhizopus infections associated with Elastoplast wound dressings—Minnesota
MMWR
Cited by (0)
- ☆
Reprint requests: SSI Guideline, Hospital Infections Program, Mailstop E-69, Center for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333. The “Guideline for Prevention of Surgical Site Infection, 1999” is available online at www.cdc.gov/ncidod/hip.
- ☆☆
Published simultaneously in Infection Control and Hospital Epidemiology; AJIC: American Journal of Infection Control 1999;27:97-134; and the Journal of Surgical Outcomes.
- ★
Dr. Mangram is currently affiliated with the University of Texas Medical Center, Houston, Texas.
- ★★
17/52/98051