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 |