Type of prevention

Time of implementation

Grade of evidence

Avoid hair removal at the surgical site. If hair must be removed use single-patient clippers and not razors.

Preoperative phase

1A2

Wash the patient or ensure that has showered on day of or day before surgery.

Preoperative phase

1B3

Use the right drug, at the right time and for the right duration for antibiotic prophylaxis1.

Preoperative phase

1A2

Use 2% chlorhexidine gluconate in 70% isopropyl alcohol solution for skin preparation.

Intraoperative phase

1A2

Patient’s body temperature should be maintained above 36˚C during the perioperative period.

Intraoperative phase

1A2

Patient’s haemoglobin saturation should be maintained above 95% (or as high as possible).

Intraoperative phase

1B3

In diabetic patient the glucose level should be kept at <200 mg/dl throughout the operation.

Intraoperative phase

1B3

Give one additional antibiotic dose if the surgical procedure lasts more than 4 hours or there is major intra-operative blood loss (>1.5 litres).

Intraoperative phase

1A2

Cover the surgical site with a sterile wound dressing before to remove drapes at the end of surgery.

Intraoperative phase

1A2

Do not tamper with or remove the wound dressing for 48 hours post-op, unless clinically indicated.

Postoperative phase

II

Use aseptic technique for surgical site inspection and/or wound dressing changes.

Postoperative phase

1A2

Hand hygiene is mandatory before and after every time the wound is inspected or the dressing is changed.

Postoperative phase

1B3