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