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Site Infection
This updates the 1999 original, published before formal
evidence-based guidelines were in routine use.
I
n May, the Healthcare Infec- prosthetic joint arthroplasty, which
tion Control Practices Advi- the authors identify as procedures
sory Committee (HICPAC) in which the human and financial
of the Centers for Disease Control burden [of SSI] is greatest. There
and Prevention released their 2017 are few recommendations in this
Guideline for the Prevention of section; most of the issues raised
Surgical Site Infection (http://bit. are designated as unresolved.
ly/2pJXz7l). This long-awaited Among the six interventions
guideline updates the 1999 origi- that apply to all types of surgeries,
nal, which was published before new category IA and IB recom-
formal evidence-based guidelines mendations include a perioperative
were in routine use and relied blood glucose target of less than
heavily on expert opinion in lieu 200 mg/dL for patients with and
of clinical or epidemiological without diabetes, a pre-op shower
studies. or bath with either an antiseptic/
The new guideline uses a modi- antimicrobial soap or plain soap,
fied Grading of Recommendations, the use of an alcohol-based anti-
Assessment, Development, and septic skin prep, the perioperative
Evaluation (GRADE) approach to maintenance of normothermia,
link the quality of evidence to the and the administration of anti-
strength of its recommendations. microbial prophylaxis for cesar-