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CDC to release updated guideline for the prevention of surgical site infection
When issued, the guideline will reflect the lack of evidence for some common practices.
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In 1999, the CDC issued the Guideline for Prevention of Surgical Site Infection. Although the guideline was a series of recommendations for the prevention of surgical site infections made by a panel of experts, they have served the surgical community for many years.
The CDC recently revisited the issue and soon will publish an updated guideline for the prevention of surgical site infection. The new guideline differs from the 1999 recommendations in two major ways: 1) the guideline is evidence-based; and 2) there is a series of separate guidelines relevant to orthopedic surgery.
Supporting evidence
To accomplish this task, the CDC convened a large workgroup consisting of experts and representatives from numerous societies, including the American Academy of Orthopaedic Surgeons and the MusculoSkeletal Infection Society, to evaluate the available literature and to issue the revised guideline.
Javad Parvizi
The guideline is divided into two sections: the core section addresses recommendations applicable across a broad spectrum of surgical procedures and the new procedure-specific component section focuses on a single, high-volume, high-burden surgical procedures. The first of these component sections focuses on arthroplasty procedures.
One of the sobering discoveries the workgroup found was that there is little evidence to support many daily practices applicable to the prevention of infection. Thus, the revised guideline, when issued, will reflect the lack of evidence for some established and common practices. However, there will be many other recommendations that are based on available evidence, such as the importance of administration of perioperative antibiotics.
Recommendations
The CDC and numerous experts who served in the workgroup have invested huge efforts to produce the updated guideline. The literature has been evaluated extensively. Many conference calls have taken place to discuss the issues, when necessary. In addition, the recommendations have been carefully evaluated by the Healthcare Infection Control Practices Advisory Committee.
When issued, the updated guideline will no doubt play a critical role to help orthopedic surgeons make strides in the reduction of the burden of this dreaded complication. The guideline will also provide a great impetus for the medical community to generate and to seek evidence for practices that currently lack such evidence.
- Reference:
- www.cdc.gov/hicpac/SSI/001_SSI.html
- For more information:
- Javad Parvizi, MD, FRCS, can be reached at Rothman Institute at Thomas Jefferson University Hospital, Sheridan Building, Suite 1000, 125 S. 9th St., Philadelphia, PA 19107; email: parvj@aol.com.
Disclosure: Parvizi reports he is a consultant to ZimmerBiomet, Ceramtec, Convatec and TissueGene. He has ownership in CD Diagnostics, Hip Innovation Technology, ForMD, Alphaeon, and Joint Purification Systems.