Prevention of surgical-site infections: paradoxes in surgical dogma and sustainability

Of all hospital-acquired infections, surgical-site infections (SSIs) accounted for 16% in a recent European study¹. These infections have significant consequences for patients, in terms of morbidity, pain, and, sometimes, even death, as well as increased durations of hospital stay and significantly increased healthcare costs². Guidelines to prevent SSIs have been produced in the UK and beyond, to assist in prevention, and these often categorize measures into preoperative, perioperative, and postoperative interventions^3,4. For example, the application of alcohol-based disinfectants is recommended for the surgical site before surgery, maintaining a normal blood glucose level and avoiding hypothermia are advised for the intraoperative phase, and removing drains when clinically indicated is advocated in the postoperative interval.