Background and Evidence
Despite the intention to predict the development of negative postoperative outcomes, achieving the desired goals is impossible, and surgical site infections (SSIs) remain common in many patients. This type of infection usually occurs after surgery in the place where the operative intervention took place (Centers for Disease Control and Prevention, 2019). SSIs may be superficial, involving only skin damage, deep penetrating the nearest tissues and muscles, and deep space when any body’s area is damaged (Centers for Disease Control and Prevention, 2019; van Niekerk et al., 2020). Major symptoms include redness, pain, fluid from the wound, edema, and fever (Kolasiński, 2019). Sometimes, patients do not recognize the SSI primary signs, which requires careful attention and regular assessments by healthcare providers.
The problem of postoperative infections motivates many researchers and medical experts to initiate new studies and find appropriate preventive techniques. For example, about 80 million surgeries end with SSIs in the United States in about 2%, and the global rating of such infections is about 38% (as cited in Borchardt & Tzizik, 2018). In the European context, the number varies from 5.3 to 18%, increasing morbidity, mortality, and healthcare costs (as cited in Tomsic et al., 2020). The bacteria (germs) become one of the causes of SSIs in most cases, and it is important to treat the infection as early as possible to avoid health complications (Centers for Disease Control and Prevention, 2019). However, not all surgeries should end with infections, depending on the surgery quality, surgeon professionalism, genetic factors, and the environment.
Considering the characteristics and causes of SSIs, many professional profit and non-profit organizations aim to develop effective recommendations. Almost every decade, the Centers for Disease Control and Prevention and the World Health Organizations release their guidelines, addressing recent observations and finding (Borchardt & Tzizik, 2018). The prevention of SSI should be promoted at different surgery stages: before (patient history assessment, attention to medical history, hand hygiene, and wearing protective clothes), during (regular observations and communication), and after (distance and care). Healthcare providers should also consider the worth of audits, monitoring, reminders, and education to maintain a healthy environment and safe organizational culture (Tomsic et al., 2020). However, preoperative antibiotics remain one of the regular and efficient interventions to help people prevent SSI or minimize health complications.
Preoperative antibiotic therapy is a preferred pharmacological intervention to reduce SSI frequency. Antibiotic prophylaxis allows for cleaning wounds and helps the body cope with the current health problem (Tomsic et al., 2020). Weight-based dosing and follow-up are obligatory steps to ensure positive results (Borchardt & Tzizik, 2018). Age, chronic diseases, nutritional status, and lifestyle are patient-dependent factors, while the quality of preoperative procedures and sterilization are staff responsibilities (Kolasiński, 2019). All these elements play a crucial role in understanding SSIs and prevention success.
Problem Statement
Despite high readiness and professionalism among healthcare providers, many patients develop SSIs and require timely antibiotic administration before and after surgery. Patients have personal health characteristics and different care access, and the most appropriate anti-infectives and non-pharmacological steps should be chosen and combined to predict complications, relying on disordered and constantly changing results of systematic reviews.
Purpose Statement
The current systematic review will examine the recent recommendations developed by professional organizations and mentioned in peer-reviewed articles to identify effective preoperative and postoperative pharmacological and non-pharmacological interventions to promote SSI prevention in patients.
References
Borchardt, R. A., & Tzizik, D. (2018). Update on surgical site infections: The new CDC guidelines. Journal of the American Academy of Pas, 31(4), 52-54. Web.
Centers for Disease Control and Prevention. (2019). Frequently asked questions about surgical site infections. CDC. Web.
Kolasiński, W. (2019). Surgical site infections – Review of current knowledge, methods of prevention. Polish Journal of Surgery, 91, 41-47. Web.
Tomsic, I., Heinze, N. R., Chaberny, I. F., Krauth, C., Schock, B., & von Lengerke, T. (2020). Implementation interventions in preventing surgical site infections in abdominal surgery: A systematic review. BMC Health Services Research, 20(1). Web.
van Niekerk, J. M., Vos, M. C., Stein, A., Braakman-Jansen, L. M. A., Voor In’t Holt, A. F., & van Gemert-Pijnen, J. E. W. C. (2020). Risk factors for surgical site infections using a data-driven approach. PloS One, 15(10). Web.