How To Prevent Surgical Site Infections

Surgery and emergency concept. Professional Medical Doctors Performing Surgery

Every year, 15 million Americans undergo a surgical procedure, hoping to repair damage and bring healing to their medical challenges. 


Many will walk out well, but some – up to three percent, according to JAMA – will experience an infection “at or adjacent to the surgical incision site.” This means that hundreds of thousands of patients will experience a surgical site infection (SSI) annually, increasing hospital stays by 7 to 11 days on average, eroding healthcare outcomes, damaging the reputations of physicians and healthcare facilities, and increasing costs for patients and healthcare providers. 


More specifically, SSIs often result in readmissions, additional testing, antibiotic treatments, and additional surgical procedures, ballooning expenses and exposing patients to additional risks. 


As the National Library of Medicine concludes, “The need to treat SSIs places a severe financial strain on health care resources.”


However, SSIs aren’t inevitable, and healthcare providers can take intentional steps to reduce patient exposure to infectious diseases. In fact, according to AORN Journal, “Approximately 55% of SSIs could be avoided if health care personnel adhered to evidence-based prevention strategies.”


Here are the top five ways to prevent surgical site infections at your healthcare facility. 

1. Appropriately Disinfect the Surgical Setting

It may seem obvious that surgical sites must be decontaminated and sterilized before every use. However, some cleaning regimens, often the first defense against contaminated spaces, are less effective than many realize. 


As we recently covered in a separate article, manual cleaning makes it frighteningly likely that viruses and bacteria are not being eradicated, but rather being transported. One study found that “Cross-contamination among surfaces following terminal cleaning alone was documented in 50% of the total samples.”


With just 29 percent of high touch OR surfaces properly cleaned, healthcare providers need an efficient and effective method to disinfect the surgical setting quickly and completely before and after a procedure. As the CDC notes, this is especially true for surfaces “in close proximity to the patient and frequently touched surfaces in the patient care environment on a more frequent schedule compared to other surfaces.” 


Notably, healthcare providers must use EPA-registered disinfectants that eradicate the pathogens that are most likely to contaminate the sterile surgical environment. 


Fogging technologies that leverage hypochlorous acid (HOCl) can effectively address these challenges, providing 100 percent HOCl surface contact and eliminating the unpredictability of manual cleaning without compromising efficacy.

2. Prepare Patients to Take Proactive, Preventative Cleaning Procedures

To prevent SSIs, patients should bathe in soap or antiseptic solution before a procedure. AORN explains that risk factors for SSIs include “a patient’s endogenous or extrinsic bacteria that colonize areas away from the surgical site.” 


Chlorhexidine gluconate (CHG) is commonly used due to its effectiveness against a wide range of bacteria, fungi, and some viruses. This is crucial because SSIs can be caused by bacteria from different parts of the body, not just the surgery site. CHG is available as 2% impregnated cloth or 4% liquid soap.


Therefore, in collaboration with perioperative leaders, nurses, physicians, and infection prevention experts, healthcare facilities should choose an appropriate CHG product and include it in their standard SSI-prevention protocols. 


Of course, pathogens aren’t just endogenous to the patient. They are inherent in the environment. According to a recent study on the rapid environmental contamination of C-Auris, more than 20 percent of surfaces were still contaminated four hours post cleaning, putting patients at risk when they enter the OR. 

3. Maintain Hand Hygiene 

Regular hand cleaning is a simple and effective way to stop the spread of germs, including those that cause surgical infections. This can be done by washing hands with soap and water or using an alcohol-based hand sanitizer. 


According to the CDC, “Unless hands are visibly soiled, an alcohol-based hand rub is preferred over soap and water in most clinical situations due to evidence of better compliance compared to soap and water. Hand rubs are generally less irritating to hands and are effective in the absence of a sink.”


Specifically, healthcare professionals should use alcohol-based hand rub or wash with soap:


  • Immediately before touching a patient
  • Before using an invasive medical device 
  • Before moving from work on a soiled body site to a clean body site
  • After touching a patient or the patient’s environment 
  • After contact with bodily fluids
  • After glove removal. 

In short, for surgical procedures, healthcare professionals should use specialized hand-cleaning methods, like alcohol-based rubs or scrubs, and remove any hand and arm jewelry first. 

4. Pay Attention to Surgical Attire 

AORN recommends that personnel only wear clean surgical scrubs, including dresses, tops, pants, jackets, head coverings, and shoes, before entering a surgical setting. 


AORN’s most recent surgical attire recommendations provide guidance on laundering these items, encouraging healthcare providers to use healthcare-accredited laundry facilities or properly equipped on-site facilities to clean and disinfect surgical attire. The association also recommends avoiding the use of home laundry machines or retail detergents to clean contaminated surgical attire. 


Appropriately laundering surgical attire lowers the risk of SSIs, ensuring that sterilized rooms and prepared patients have the best chance of success. 

5. Measure Success and Keep Improving 

To be sure, SSI prevention is a highly localized and evolving practice, requiring healthcare providers to understand their environment and make iterative improvements that address their specific challenges. 


As the National Library of Medicine explains, “Successful implementation of SSI prevention strategies requires multimodal interventions tailored to institution-specific strengths and weaknesses, rather than one-size-fits-all guidelines.”


To help achieve this at the local level, measure the impact of implemented SSI prevention strategies, including tracking SSI rates, patient outcomes, and patient/caregiver feedback. By analyzing these metrics, providers can continually improve their practices and elevate patient well-being. 


In the process, know that you’re not alone. Nevoa is your partner in preventing SSIs. From automated disinfection technology that streamlines OR disinfection to a proprietary HOCl solution that’s pH neutral, non-toxic, and 80 – 100x more effective than bleach, Nevoa has solutions to help improve OR safety. 


Contact us today to learn more about how we can partner with you to reduce the impact of SSIs at your local facility. 

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