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Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

Published online by Cambridge University Press:  10 May 2016

Deverick J. Anderson
Duke University Medical Center, Durham, North Carolina
Kelly Podgorny
The Joint Commission, Oakbrook Terrace, Illinois
Sandra I. Berríos-Torres
Centers for Disease Control and Prevention, Atlanta, Georgia
Dale W. Bratzler
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
E. Patchen Dellinger
University of Washington Medical Center, Seattle, Washington
Linda Greene
Highland Hospital andUniversity of Rochester Medical Center, Rochester, New York
Ann-Christine Nyquist
Children’s Hospital Colorado andUniversity of Colorado School of Medicine, Aurora, Colorado
Lisa Saiman
Columbia University Medical Center, New York, New York
Deborah S. Yokoe
Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
Lisa L. Maragakis
Johns Hopkins University School of Medicine, Baltimore, Maryland
Keith S. Kaye
Detroit Medical Center and Wayne State University, Detroit, Michigan
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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their surgical site infection (SSI) prevention efforts. This document updates “Strategies to Prevent Surgical Site Infections in Acute Care Hospitals,” published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

SHEA/IDSA Practice Recommendation
Copyright © The Society for Healthcare Epidemiology of America 2014


1. Anderson, DJ, Kaye, KS, Classen, D, et al. Strategies to prevent surgical site infections in acute care hospitals. Infect Control Hosp Epidemiol 2008;29(suppl 1):S51S61.CrossRefGoogle ScholarPubMed
2. Yokoe, DS, Anderson, DJ, Berenholtz, SM, et al. Introduction to “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates.Infect Control Hosp Epidemiol 2014;35(5):455459.Google Scholar
3. Cruse, P. Wound infection surveillance. Rev Infect Dis 1981;3(4):734737.CrossRefGoogle ScholarPubMed
4. Graves, EJ. National Hospital Discharge Survey: Annual Summary, 1987. Series 13, no. 99. Hyattsville, MD: National Center for Health Statistics, 1989.Google Scholar
5. Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project—statistics on hospital stays. 2013. Accessed February 15, 2013.Google Scholar
6. Scott, RD. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Atlanta: Centers for Disease Control and Prevention, 2009. Accessed December 14, 2013.Google Scholar
7. Anderson, DJ, Pyatt, DG, Weber, DJ, Rutala, WA. Statewide costs of health care-associated infections: estimates for acute care hospitals in North Carolina. Am J Infect Control 2013;41(9): 764768.Google Scholar
8. Lewis, SS, Moehring, RW, Chen, LF, Sexton, DJ, Anderson, DJ. Assessing the relative burden of hospital-acquired infections in a network of community hospitals. Infect Control Hosp Epidemiol 2013;34(11):12291230.CrossRefGoogle Scholar
9. Zimlichman, E, Henderson, D, Tamir, O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the us health care system. JAMA Intern Med 2013; 173(22):20392046.Google Scholar
10. Meeks, DW, Lally, KP, Carrick, MM, et al. Compliance with guidelines to prevent surgical site infections: as simple as 1-2-3? Am J Surg 2011;201(1):7683.CrossRefGoogle ScholarPubMed
11. Umscheid, CA, Mitchell, MD, Doshi, JA, Agarwal, R, Williams, K, Brennan, PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol 2011;32(2): 101114.CrossRefGoogle ScholarPubMed
12. Klevens, RM, Edwards, JR, Richards, CL Jr, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007;122(2):160166.CrossRefGoogle ScholarPubMed
13. Cruse, PJ, Foord, R. The epidemiology of wound infection: a 10-year prospective study of 62,939 wounds. Surg Clin North Am 1980;60(1):2740.Google Scholar
14. Anderson, DJ, Kaye, KS, Chen, LF, et al. Clinical and financial outcomes due to methicillin resistant Staphylococcus aureus surgical site infection: a multi-center matched outcomes study. PloS ONE 2009;4(12):e8305.Google Scholar
15. Engemann, JJ, Carmeli, Y, Cosgrove, SE, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis 2003;36(5):592598.Google Scholar
16. Kirkland, KB, Briggs, JP, Trivette, SL, Wilkinson, WE, Sexton, DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999;20(11):725730.CrossRefGoogle ScholarPubMed
17. Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR; Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol 1999;20(4):250278.CrossRefGoogle ScholarPubMed
18. Apisarnthanarak, A, Jones, M, Waterman, BM, Carroll, CM, Bernardi, R, Fraser, VJ. Risk factors for spinal surgical-site infections in a community hospital: a case-control study. Infect Control Hosp Epidemiol 2003;24(1):3136.CrossRefGoogle Scholar
19. Boyce, JM, Potter-Bynoe, G, Dziobek, L. Hospital reimbursement patterns among patients with surgical wound infections following open heart surgery. Infect Control Hosp Epidemiol 1990; 11(2):8993.Google Scholar
20. Coello, R, Glenister, H, Fereres, J, et al. The cost of infection in surgical patients: a case-control study. J Hosp Infect 1993;25(4): 239250.CrossRefGoogle ScholarPubMed
21. Hollenbeak, CS, Murphy, DM, Koenig, S, Woodward, RS, Dunagan, WC, Fraser, VJ. The clinical and economic impact of deep chest surgical site infections following coronary artery bypass graft surgery. Chest 2000;118(2):397402.CrossRefGoogle ScholarPubMed
22. VandeBergh, MF, Kluytmans, JA, van Hout, BA, et al. Cost-effectiveness of perioperative mupirocin nasal ointment in cardiothoracic surgery. Infect Control Hosp Epidemiol 1996;17(12): 786792.CrossRefGoogle Scholar
23. Vegas, AA, Jodra, VM, Garcia, ML. Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization. Eur J Epidemiol 1993; 9(5):504510.Google Scholar
24. Whitehouse, JD, Friedman, ND, Kirkland, KB, Richardson, WJ, Sexton, DJ. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol 2002;23(4):183189.CrossRefGoogle Scholar
25. Bozic, KJ, Katz, P, Cisternas, M, Ono, L, Ries, MD, Showstack, J. Hospital resource utilization for primary and revision total hip arthroplasty. J Bone Joint Surg Am 2005;87(3):570576.Google Scholar
26. National Healthcare Safety Network. Surgical Site Infection (SSI) Event. Atlanta: Centers for Disease Control and Prevention, 2013. Accessed May 1, 2013.Google Scholar
27. Condon, RE, Schulte, WJ, Malangoni, MA, Anderson-Teschendorf, MJ. Effectiveness of a surgical wound surveillance program. Arch Surg 1983;118(3):303307.CrossRefGoogle ScholarPubMed
28. Kerstein, M, Flower, M, Harkavy, LM, Gross, PA. Surveillance for postoperative wound infections: practical aspects. Am Surg 1978;44(4):210214.Google Scholar
29. Mead, PB, Pories, SE, Hall, P, Vacek, PM, Davis, JH Jr, Gamelli, RL. Decreasing the incidence of surgical wound infections: validation of a surveillance-notification program. Arch Surg 1986; 121(4):458461.CrossRefGoogle ScholarPubMed
30. Baker, C, Luce, J, Chenoweth, C, Friedman, C. Comparison of case-finding methodologies for endometritis after cesarean section. Am J Infect Control 1995;23(1):2733.Google Scholar
31. Cardo, DM, Falk, PS, Mayhall, CG. Validation of surgical wound surveillance. Infect Control Hosp Epidemiol 1993;14(4):211215.Google Scholar
32. Ming, DY, Chen, LF, Miller, BA, Anderson, DJ. The impact of depth of infection and postdischarge surveillance on rate of surgical-site infections in a network of community hospitals. Infect Control Hosp Epidemiol 2012;33(3):276282.CrossRefGoogle Scholar
33. Chalfine, A, Cauet, D, Lin, WC, et al. Highly sensitive and efficient computer-assisted system for routine surveillance for surgical site infection. Infect Control Hosp Epidemiol 2006;27(8): 794801.CrossRefGoogle ScholarPubMed
34. Miner, AL, Sands, KE, Yokoe, DS, et al. Enhanced identification of postoperative infections among outpatients. Emerg Infect Dis 2004;10(11):19311937.CrossRefGoogle ScholarPubMed
35. Yokoe, DS, Noskin, GA, Cunnigham, SM, et al. Enhanced identification of postoperative infections among inpatients. Emerg Infect Dis 2004;10(11):19241930.CrossRefGoogle ScholarPubMed
36. Calderwood, MS, Kleinman, K, Bratzier, DW, et al. Use of Medicare claims to identify US hospitals with a high rate of surgical site infection after hip arthroplasty. Infect Control Hosp Epidemiol 2013;34(1):3139.Google Scholar
37. Huang, SS, Placzek, H, Livingston, J, et al. Use of Medicare claims to rank hospitals by surgical site infection risk following coronary artery bypass graft surgery. Infect Control Hosp Epidemiol 2011;32(8):775783.Google Scholar
38. Haley, VB, Van Antwerpen, C, Tserenpuntsag, B, et al. Use of administrative data in efficient auditing of hospital-acquired surgical site infections, New York State 2009-2010. Infect Control Hosp Epidemiol 2012;33(6):565571.Google Scholar
39. Burke, JP. Infection control—a problem for patient safety. N Engl J Med 2003;348(7):651656.Google Scholar
40. Cullen, KA, Hall, MJ, Golosinkiy, A. Ambulatory surgery in the United States, 2006. Nati Health Stat Report 2009;(11):125.Google Scholar
41. National action plan to prevent health care-associated infections: roadmap to elimination; ambulatory surgical centers. Department of Health and Human Services website, Accessed January 4, 2013.Google Scholar
42. Consensus paper on the surveillance of surgical wound infections. The Society for Hospital Epidemiology of America; the Association for Practitioners in Infection Control; the Centers for Disease Control; the Surgical Infection Society. Infect Control Hosp Epidemiol 1992;13(10):599605.Google Scholar
43. Mannien, J, Wille, JC, Snoeren, RL, van den Hof, S. Impact of postdischarge surveillance on surgical site infection rates for several surgical procedures: results from the nosocomial surveillance network in the Netherlands. Infect Control Hosp Epidemiol 2006;27(8):809816.CrossRefGoogle Scholar
44. Kent, P, McDonald, M, Harris, O, Mason, T, Spelman, D. Post-discharge surgical wound infection surveillance in a provincial hospital: follow-up rates, validity of data and review of the literature. ANZJ Surg 2001;71(10):583589.Google Scholar
45. Manian, FA. Surveillance of surgical site infections in alternative settings: exploring the current options. Am J Infect Control 1997;25(2):102105.Google Scholar
46. Michelson, J. Improved detection of orthopaedic surgical site infections occurring in outpatients. Clin Orthop Relat Res 2005(433):218224.Google Scholar
47. Nafziger, DA, Lundstrom, T, Chandra, S, Massanari, RM. Infection control in ambulatory care. Infect Dis Clin North Am 1997; 11(2):279296.Google Scholar
48. Petherick, ES, Dalton, JE, Moore, PJ, Cullum, N. Methods for identifying surgical wound infection after discharge from hospital: a systematic review. BMC Infect Dis 2006;6:170.Google Scholar
49. Mlangeni, D, Babikir, R, Dettenkofer, M, Daschner, F, Gastmeier, P, Ruden, H. AMBU-KISS: quality control in ambulatory surgery. Am J Infect Control 2005;33(1):1114.CrossRefGoogle ScholarPubMed
50. Whitby, M, McLaws, ML, Collopy, B, et al. Post-discharge surveillance: can patients reliably diagnose surgical wound infections? J Hosp Infect 2002;52(3):155160.Google Scholar
51. Manian, FA, Meyer, L. Comparison of patient telephone survey with traditional surveillance and monthly physician questionnaires in monitoring surgical wound infections. Infect Control Hosp Epidemiol 1993;14(4):216218.Google Scholar
52. Prospero, E, Cavicchi, A, Bacelli, S, Barbadoro, P, Tantucci, L, D’Errico, MM. Surveillance for surgical site infection after hospital discharge: a surgical procedure-specific perspective. Infect Control Hosp Epidemiol 2006;27(12):13131317.CrossRefGoogle ScholarPubMed
53. Sands, K, Vineyard, G, Platt, R. Surgical site infections occurring after hospital discharge. J Infect Dis 1996;173(4):963970.Google Scholar
54. Healthcare-Associated Infection Working Group of the Joint Public Policy Committee. Essentials of Public Reporting of Healthcare-Associated Infections: A Tool Kit. 2007. _Tool_Kit.pdf. Accessed January 5, 2013.Google Scholar
55. National Quality Forum (NQF). National Voluntary Consensus Standards for the Reporting of Healthcare-Associated Infection Data. Washington, DC: NQF, 2008. _Infection_Data.aspx. Accessed January 6, 2013.Google Scholar
56. National Institute for Health and Clinical Excellence (NICE). Surgical Site Infection: Prevention and Treatment of Surgical Site Infection. London: NICE, 2008. Accessed February 12, 2013.Google Scholar
57. Bratzler, DW, Houck, PM. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis 2004;38(12):17061715.Google Scholar
58. Bratzler, DW, Hunt, DR. The surgical infection prevention and surgical care improvement projects: national initiatives to improve outcomes for patients having surgery. Clin Infect Dis 2006;43(3):322330.Google Scholar
59. Dellinger, EP, Hausmann, SM, Bratzler, DW, et al. Hospitals collaborate to decrease surgical site infections. Am J Surg 2005; 190(1):915.Google Scholar
60. National Quality Forum (NQF). Cardiac Surgery Patients with Controlled Postoperative Blood Glucose. Washington, DC: NQF, 2013. Accessed January 6, 2013.Google Scholar
61. Lazar, HL, McDonnell, M, Chipkin, SR, et al. The Society of Thoracic Surgeons practice guideline series: blood glucose management during adult cardiac surgery. Ann Thorac Surg 2009;87(2):663669.Google Scholar
62. A resource from the Institute of Healthcare Improvement. Institute for Healthcare Improvement (IHI) website, Accessed January 31, 2007.Google Scholar
63. Griffin, FA. Reducing surgical complications. Jt Comm J Qual Patient Saf 2007;33(11):660665.Google Scholar
64. The Joint Commission. National Patient Safety Goals Effective January 1, 2013. Oakbrook Terrace, IL: The Joint Commission, 2013. http://www.jointcommission.Org/assets/l/l8/NPSG_Chapter_Jan2013_HAP.pdf. Accessed March 1, 2013.Google Scholar
65. Centers for Medicare & Medicaid Services. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2013 rates; hospitals’ resident caps for graduate medical education payment purposes; quality reporting requirements for specific providers and for ambulatory surgical centers. Final rule. Fed Regist 2012;77(170):5325753750.Google Scholar
66. Centers for Medicare & Medicaid Services. Medicare program; hospital inpatient value-based purchasing program. Final rule. Fed Regist 2011;76(88):2649026547.Google Scholar
67. van Kasteren, ME, Mannien, J, Kullberg, BJ, et al. Quality improvement of surgical prophylaxis in Dutch hospitals: evaluation of a multi-site intervention by time series analysis. J Antimicrob Chemother 2005;56(6):10941102.Google Scholar
68. Schweon, S. Stamping out surgical site infections. RN 2006; 69(8):3640.Google Scholar
69. Torpy, JM, Burke, A, Glass, RM. JAMA patient page: wound infections. JAMA 2005;294(16):2122.Google Scholar
70. Kanter, G, Connelly, NR, Fitzgerald, J. A system and process redesign to improve perioperative antibiotic administration. Anesth Analg 2006;103(6):15171521.Google Scholar
71. Pestotnik, SL, Classen, DC, Evans, RS, Burke, JP. Implementing antibiotic practice guidelines through computer-assisted decision support: clinical and financial outcomes. Ann Intern Med 1996;124(10):884890.Google Scholar
72. Webb, AL, Flagg, RL, Fink, AS. Reducing surgical site infections through a multidisciplinary computerized process for preoperative prophylactic antibiotic administration. Am J Surg 2006; 192(5):663668.Google Scholar
73. Nair, BG, Newman, SF, Peterson, GN, Wu, WY, Schwid, HA. Feedback mechanisms including real-time electronic alerts to achieve near 100% timely prophylactic antibiotic administration in surgical cases. Anesth Analg 2010;111(5):12931300.Google Scholar
74. Berger, RG, Kichak, JP. Computerized physician order entry: helpful or harmful? J Am Med Inform Assoc 2004;11(2):100103.Google Scholar
75. Antimicrobial prophylaxis for surgery. Treat Guidel Med Lett 2009;7(82):4752.Google Scholar
76. Bratzler, DW, Dellinger, EP, Olsen, KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm 2013;70(3): 195283.Google Scholar
77. Steinberg, JP, Braun, BI, Hellinger, WC, et al. Timing of antimicrobial prophylaxis and the risk of surgical site infections: results from the Trial to Reduce Antimicrobial Prophylaxis Errors. Ann Surg 2009;250(1):1016.Google Scholar
78. van Kasteren, ME, Mannien, J, Ott, A, Kullberg, BJ, de Boer, AS, Gyssens, IC. Antibiotic prophylaxis and the risk of surgical site infections following total hip arthroplasty: timely administration is the most important factor. Clin Infect Dis 2007;44(7): 921927.Google Scholar
79. Soriano, A, Bori, G, Garcia-Ramiro, S, et al. Timing of antibiotic prophylaxis for primary total knee arthroplasty performed during ischemia. Clin Infect Dis 2008;46(7):10091014.Google Scholar
80. Akinyoola, AL, Adegbehingbe, OO, Odunsi, A. Timing of antibiotic prophylaxis in tourniquet surgery. J Foot Ankle Surg 2011;50(4):374376.Google Scholar
81. Harbarth, S, Samore, MH, Lichtenberg, D, Carmeli, Y. Prolonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance. Circulation 2000;101(25):29162921.Google Scholar
82. McDonald, M, Grabsch, E, Marshall, C, Forbes, A. Single-versus multiple-dose antimicrobial prophylaxis for major surgery: a systematic review. Aust N ZJ Surg 1998;68(6):388396.CrossRefGoogle ScholarPubMed
83. Coakley, BA, Sussman, ES, Wolfson, TS, et al. Postoperative antibiotics correlate with worse outcomes after appendectomy for nonperforated appendicitis. J Am Coll Surg 2011;213(6):778783.Google Scholar
84. Cannon, JA, Altom, LK, Deierhoi, RJ, et al. Preoperative oral antibiotics reduce surgical site infection following elective co-lorectal resections. Dis Colon Rectum 2012;55(11):11601166.CrossRefGoogle Scholar
85. Englesbe, MJ, Brooks, L, Kubus, J, et al. A statewide assessment of surgical site infection following colectomy: the role of oral antibiotics. Ann Surg 2010;252(3):514519.Google Scholar
86. Fry, DE. Colon preparation and surgical site infection. Am J Surg 2011;202(2):225232.CrossRefGoogle ScholarPubMed
87. Hendren, S, Fritze, D, Banerjee, M, et al. Antibiotic choice is independently associated with risk of surgical site infection after colectomy: a population-based cohort study. Ann Surg 2013;257(3):469475.Google Scholar
88. Lewis, RT. Oral versus systemic antibiotic prophylaxis in elective colon surgery: a randomized study and meta-analysis send a message from the 1990s. Can J Surg 2002;45(3):173180.Google Scholar
89. Nelson, RL, Glenny, AM, Song, F. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev 2009;(1):CD001181.Google Scholar
90. Deierhoi, RJ, Dawes, LG, Vick, C, Itani, KM, Hawn, MT. Choice of intravenous antibiotic prophylaxis for colorectal surgery does matter. J Am Coll Surg 2013;217(5):763769.Google Scholar
91. Toneva, GD, Deierhoi, RJ, Morris, M, et al. Oral antibiotic bowel preparation reduces length of stay and readmissions after colorectal surgery. J Am Coll Surg 2013;216(4):756762.Google Scholar
92. Guenaga, KF, Matos, D, Wille-Jorgensen, R Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev 2011;(9):CD001544.Google Scholar
93. Tanner, J, Woodings, D, Moncaster, K. Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev 2006;(3):CD004122.Google Scholar
94. Dronge, AS, Perkal, MF, Kancir, S, Concato, J, Asian, M, Rosenthal, RA. Long-term glycémie control and postoperative infectious complications. Arch Surg 2006;141(4):375380.Google Scholar
95. Golden, SH, Peart-Vigilance, C, Kao, WH, Brancati, FL. Perioperative glycemic control and the risk of infectious complications in a cohort of adults with diabetes. Diabetes Care 1999; 22(9):14081414.Google Scholar
96. Olsen, MA, Nepple, JJ, Riew, KD, et al. Risk factors for surgical site infection following orthopaedic spinal operations. J Bone Joint Surg Am 2008;90(1):6269.Google Scholar
97. Kwon, S, Thompson, R, Dellinger, P, Yanez, D, Farrohki, E, Flum, D. Importance of perioperative glycemic control in general surgery: a report from the Surgical Care and Outcomes Assessment Program. Ann Surg 2013;257(1):814.Google Scholar
98. Umpierrez, GE, Smiley, D, Jacobs, S, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diabetes Care 2011;34(2):256261.Google Scholar
99. Jacobi, J, Bircher, N, Krinsley, J, et al. Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Crit Care Med 2012;40(12):32513276.Google Scholar
100. Umpierrez, GE, Hellman, R, Korytkowski, MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrino J Metab 2012;97(1):1638.Google Scholar
101. Gandhi, GY, Nuttall, GA, Abel, MD, et al. Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial. Ann Intern Med 2007;146(4):233243.Google Scholar
102. Sessler, DI. Complications and treatment of mild hypothermia. Anesthessiology 2001;95(2):531543.Google Scholar
103. Kurz, A, Sessler, DI, Lenhardt, R; Study of Wound Infection and Temperature Group. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitali-zation. N Engl J Med 1996;334(19):12091215.Google Scholar
104. Melling, AC, Ali, B, Scott, EM, Leaper, DJ. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial. Lancet 2001;358(9285): 876880.Google Scholar
105. Wong, PF, Kumar, S, Bohra, A, Whetter, D, Leaper, DJ. Randomized clinical trial of perioperative systemic warming in major elective abdominal surgery. Br J Surg 2007;94(4):421426.Google Scholar
106. Belda, FJ, Aguilera, L, Garcia de la Asuncion, J, et al. Supplemental perioperative oxygen and the risk of surgical wound infection: a randomized controlled trial. JAMA 2005;294(16): 20352042.Google Scholar
107. Greif, R, Akca, O, Horn, EP, Kurz, A, Sessler, DI; Outcomes Research Group. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. N Engl J Med 2000; 342(3):161167.CrossRefGoogle ScholarPubMed
108. Bickel, A, Gurevits, M, Vamos, R, Ivry, S, Eitan, A. Perioperative hyperoxygenation and wound site infection following surgery for acute appendicitis: a randomized, prospective, controlled trial. Arch Surg 2011;146(4):464470.Google Scholar
109. Meyhoff, CS, Wetterslev, J, Jorgensen, LN, et al. Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial. JAMA 2009;302(14):15431550.Google Scholar
110. Pryor, KO, Fahey, TJ 3rd, Lien, CA, Goldstein, PA. Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population: a randomized controlled trial. JAMA 2004;291(1):7987.Google Scholar
111. Schietroma, M, Carlei, F, Cecilia, EM, Piccione, F, Bianchi, Z, Amicucci, G. Colorectal infraperitoneal anastomosis: the effects of perioperative supplemental oxygen administration on the anastomotic dehiscence. J Gastrointest Surg 2012;16(2):427434.Google Scholar
112. Schietroma, M, Cecilia, EM, Carlei, F, et al. Prevention of anastomotic leakage after total gastrectomy with perioperative supplemental oxygen administration: a prospective randomized, double-blind, controlled, single-center trial. Ann Surg Oncol 2013;20(5):15841590.Google Scholar
113. Meyhoff, CS, Jorgensen, LN, Wetterslev, J, Christensen, KB, Rasmussen, LS. Increased long-term mortality after a high perioperative inspiratory oxygen fraction during abdominal surgery: follow-up of a randomized clinical trial. Anesth Analg 2012; 115(4):849854.Google Scholar
114. Qadan, M, Akca, O, Mahid, SS, Hornung, CA, Polk, HC Jr. Perioperative supplemental oxygen therapy and surgical site infection: a meta-analysis of randomized controlled trials. Arch Surg 2009;144(4):359366.Google Scholar
115. Maiwald, M, Chan, ES. The forgotten role of alcohol: a systematic review and meta-analysis of the clinical efficacy and perceived role of chlorhexidine in skin antisepsis. PloS ONE 2012;7(9):e44277.Google Scholar
116. Darouiche, RO, Wall, MJ Jr, Itani, KM, et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Engl J Med 2010;362(1):1826.Google Scholar
117. Swenson, BR, Hedrick, TL, Metzger, R, Bonatti, H, Pruett, TL, Sawyer, RG. Effects of preoperative skin preparation on postoperative wound infection rates: a prospective study of 3 skin preparation protocols. Infect Control Hosp Epidemiol 2009; 30(10):964971.Google Scholar
118. Aly, R, Maibach, HI. Comparative antibacterial efficacy of a 2-minute surgical scrub with chlorhexidine gluconate, povidone-iodine, and chloroxylenol sponge-brushes. Am J Infect Control 1988;16(4):173177.Google Scholar
119. Larson, E. Guideline for use of topical antimicrobial agents. Am J Infect Control 1988;16(6):253266.Google Scholar
120. Edwards, JP, Ho, AL, Tee, MC, Dixon, E, Ball, CG. Wound protectors reduce surgical site infection: a meta-analysis of randomized controlled trials. Ann Surg 2012;256(1):5359.Google Scholar
121. Haynes, AB, Weiser, TG, Berry, WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009;360(5):491499.CrossRefGoogle Scholar
122. Weiser, TG, Haynes, AB, Dziekan, G, Berry, WR, Lipsitz, SR, Gawande, AA. Effect of a 19-item surgical safety checklist during urgent operations in a global patient population. Ann Surg 2010;251(5):976980.Google Scholar
123. van Klei, WA, Hoff, RG, van Aarnhem, EE, et al. Effects of the introduction of the WHO “Surgical Safety Checklist” on in hospital mortality: a cohort study. Ann Surg 2012;255(1):4449.CrossRefGoogle ScholarPubMed
124. Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121(2):182205.Google Scholar
125. Lee, JT. Wound infection surveillance. Infect Dis Clin North Am 1992;6(3):643656.Google Scholar
126. Calderwood, MS, Ma, A, Khan, YM, et al. Use of Medicare diagnosis and procedure codes to improve detection of surgical site infections following hip arthroplasty, knee arthroplasty, and vascular surgery. Infect Control Hosp Epidemiol 2012;33(1):4049.Google Scholar
127. Bolon, MK, Hooper, D, Stevenson, KB, et al. Improved surveillance for surgical site infections after orthopedic implantation procedures: extending applications for automated data. Clin Infect Dis 2009;48(9):12231229.Google Scholar
128. Gerbier-Colomban, S, Bourjault, M, Cetre, JC, Baulieux, J, Metzger, MH. Evaluation study of different strategies for detecting surgical site infections using the hospital information system at Lyon University Hospital, France. Ann Surg 2012;255(5): 896900.Google Scholar
129. Yokoe, DS, Khan, Y, Olsen, MA, et al. Enhanced surgical site infection surveillance following hysterectomy, vascular, and colorectal surgery. Infect Control Hosp Epidemiol 2012;33(8):768773.Google Scholar
130. Jamtvedt, G, Young, JM, Kristoffersen, DT, O’Brien, MA, Oxman, AD. Audit and feedback: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2006;(2): CD000259.Google Scholar
131. Skoufalos, A, Clarke, JL, Napp, M, et al. Improving awareness of best practices to reduce surgical site infection: a multistake-holder approach. Am J Med Qual 2012;27(4):297304.Google Scholar
132. Association of periOperative Registered Nurses. 2013. Accessed March 23, 2013.Google Scholar
133. Culver, DH, Horan, TC, Gaynes, RP, et al; National Nosocomial Infections Surveillance System. Surgical wound infection rates by wound class, operative procedure, and patient risk index. Am J Med 1991;91(3 B):152S157S.Google Scholar
134. Loftus, RW, Brown, JR, Koff, MD, et al. Multiple reservoirs contribute to intraoperative bacterial transmission. Anesth Analg 2012;114(6):12361248.Google Scholar
135. Andersson, AE, Bergh, I, Karlsson, J, Eriksson, BI, Nilsson, K. Traffic flow in the operating room: an explorative and descriptive study on air quality during orthopedic trauma implant surgery. Am J Infect Control 2012;40(8):750755.Google Scholar
136. Crolla, RM, van der Laan, L, Veen, EJ, Hendriks, Y, van Schendel, C, Kluytmans, J. Reduction of surgical site infections after implementation of a bundle of care. PloS ONE 2012;7(9):e44599.Google Scholar
137. van Rijen, M, Bonten, M, Wenzel, R, Kluytmans, J. Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers. Cochrane Database Syst Rev 2008;(4):CD006216.Google Scholar
138. Wilcox, MH, Hall, J, Pike, H, et al. Use of perioperative mupirocin to prevent methicillin-resistant Staphylococcus aureus (MRSA) orthopaedic surgical site infections. J Hosp Infect 2003; 54(31):196201.Google Scholar
139. Nicholson, MR, Huesman, LA. Controlling the usage of intra-nasal mupirocin does impact the rate of Staphylococcus aureus deep sternal wound infections in cardiac surgery patients. Am J Infect Control 2006;34(1):4448.CrossRefGoogle Scholar
140. Walsh, EE, Greene, L, Kirshner, R. Sustained reduction in methicillin-resistant Staphylococcus aureus wound infections after cardiothoracic surgery. Arch Intern Med 2011; 171(1):6873.Google Scholar
141. Bode, LG, Kluytmans, JA, Wertheim, HF, et al. Preventing surgical-site infections in nasal carriers of Staphylococcus aureus . N Engl J Med 2010;362(1):917.Google Scholar
142. Harbarth, S, Fankhauser, C, Schrenzel, J, et al. Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA 2008;299(10):11491157.Google Scholar
143. Perl, TM, Cullen, JJ, Wenzel, RP, et al. Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. N Engl J Med 2002;346(24):18711877.Google Scholar
144. Schweizer, M, Perencevich, E, McDanel, J, et al. Effectiveness of a bundled intervention of decolonization and prophylaxis to decrease Gram positive surgical site infections after cardiac or orthopedic surgery: systematic review and meta-analysis. BMJ 2013;346:f2743.Google Scholar
145. Miller, MA, Dascal, A, Portnoy, J, Mendelson, J. Development of mupirocin resistance among methicillin-resistant Staphylococcus aureus after widespread use of nasal mupirocin ointment. Infect Control Hosp Epidemiol 1996;17(12):811813.Google Scholar
146. Whiteside, OJ, Tytherleigh, MG, Thrush, S, Farouk, R, Galland, RB. Intra-operative peritoneal lavage—who does it and why? Ann R Coll Surg Engl 2005;87(4):255258.Google Scholar
147. Fournel, I, Tiv, M, Soulias, M, Hua, C, Astruc, K, Aho Glele, LS. Meta-analysis of intraoperative povidone-iodine application to prevent surgical-site infection. Br J Surg 2010;97(11):16031613.Google Scholar
148. Thompson, KM, Oldenburg, WA, Deschamps, C, Rupp, WC, Smith, CD. Chasing zero: the drive to eliminate surgical site infections. Ann Surg 2011;254(3):430436.Google Scholar
149. Haessler, S, Connelly, NR, Kanter, G, et al. A surgical site infection cluster: the process and outcome of an investigation—the impact of an alcohol-based surgical antisepsis product and human behavior. Anesth Analg 2010;110(4):10441048.Google Scholar
150. Panahi, P, Stroh, M, Casper, DS, Parvizi, J, Austin, MS. Operating room traffic is a major concern during total joint arthroplasty. Clin Orthop Relat Res 2012;470(10):26902694.Google Scholar
151. Tadros, MA, Williams, VR, Plourde, S, Callery, S, Simor, AE, Vearncombe, M. Risk factors for Staphylococcus aureus surgical site infection during an outbreak in patients undergoing cardiovascular surgery. Am J Infect Control 2013;41(6):509512.Google Scholar
152. Wiener-Well, Y, Galuty, M, Rudensky, B, Schlesinger, Y, Attias, D, Yinnon, AM. Nursing and physician attire as possible source of nosocomial infections. Am J Infect Control 2011;39(7):555559.Google Scholar
153. Wright, SN, Gerry, JS, Busowski, MT, et al. Gordonia bronchialis sternal wound infection in 3 patients following open heart surgery: intraoperative transmission from a healthcare worker. Infect Control Hosp Epidemiol 2012;33(12):12381241.Google Scholar
154. Kohlenberg, A, Weitzel-Kage, D, van der Linden, P, et al. Outbreak of carbapenem-resistant Pseudomonas aeruginosa infection in a surgical intensive care unit. J Hosp Infect 2010;74(4): 350357.Google Scholar
155. Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L; Healthcare Infection Control Practices Advisory Committee (HICPAC). Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006. Atlanta: Centers for Disease Control and Prevention, 2006. Accessed January 3, 2014.Google Scholar
156. Dodds Ashley, ES, Carroll, DN, Engemann, JJ, et al. Risk factors for postoperative mediastinitis due to methicillin-resistant Staphylococcus aureus . Clin Infect Dis 2004;38(11):15551560.CrossRefGoogle ScholarPubMed
157. Chambers, D, Worthy, G, Myers, L, et al. Glycopeptide vs. non-glycopeptide antibiotics for prophylaxis of surgical site infections: a systematic review. Surg Infect (Larchmt) 2010;11(5): 455462.Google Scholar
158. Bolon, MK, Morlote, M, Weber, SG, Koplan, B, Carmeli, Y, Wright, SB. Glycopeptides are no more effective than beta-lactam agents for prevention of surgical site infection after cardiac surgery: a meta-analysis. Clin Infect Dis 2004;38(10):13571363.Google Scholar
159. Bull, AL, Worth, LJ, Richards, MJ. Impact of vancomycin surgical antibiotic prophylaxis on the development of methicillin-sensitive Staphylococcus aureus surgical site infections: report from Australian Surveillance Data (VICNISS). Ann Surg 2012; 256(6):10891092.Google Scholar
160. Brennan, MF, Pisters, PW, Posner, M, Quesada, O, Shike, M. A prospective randomized trial of total parenteral nutrition after major pancreatic resection for malignancy. Ann Surg 1994; 220(4):436441.Google Scholar
161. Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. Perioperative total parenteral nutrition in surgical patients. N Engl J Med 1991;325(8):525532.Google Scholar
162. Marimuthu, K, Varadhan, KK, Ljungqvist, O, Lobo, DN. A meta-analysis of the effect of combinations of immune modulating nutrients on outcome in patients undergoing major open gastrointestinal surgery. Ann Surg 2012;255(6):10601068.Google Scholar
163. Zhang, Y, Gu, Y, Guo, T, Li, Y, Cai, H. Perioperative immuno-nutrition for gastrointestinal cancer: a systematic review of randomized controlled trials. Surg Oncol 2012;21(2):e87e95.Google Scholar
164. Elek, SD, Conen, PE. The virulence of Staphylococcus pyogenes for man: a study of the problems of wound infection. Br J Exp Pathol 1957;38(6):573586.Google Scholar
165. Nakamura, T, Kashimura, N, Noji, T, et al. Triclosan-coated sutures reduce the incidence of wound infections and the costs after colorectal surgery: a randomized controlled trial. Surgery 2013;153(4):576583.Google Scholar
166. Chang, WK, Srinivasa, S, Morton, R, Hill, AG. Triclosan-impregnated sutures to decrease surgical site infections: systematic review and meta-analysis of randomized trials. Ann Surg 2012;255(5):854859.Google Scholar
167. Deliaert, AE, Van den Kerckhove, E, Tuinder, S, et al. The effect of triclosan-coated sutures in wound healing: a double blind randomised prospective pilot study. J Plast Reconstr Aesthet Surg 2009;62(6):771773.Google Scholar
168. Webster, J, Alghamdi, AA. Use of plastic adhesive drapes during surgery for preventing surgical site infection. Cochrane Database Syst Rev 2007;(4):CD006353.Google Scholar
169. Cordtz, T, Schouenborg, L, Laursen, K, et al. The effect of incisional plastic drapes and redisinfection of operation site on wound infection following caesarean section. J Hosp Infect 1989;13(3):267272.Google Scholar
170. Dewan, PA, Van Rij, AM, Robinson, RG, Skeggs, GB, Fergus, M. The use of an iodophor-impregnated plastic incise drape in abdominal surgery—a controlled clinical trial. Aust N Z J Surg 1987;57(11):859863.Google Scholar
171. Segal, CG, Anderson, JJ. Preoperative skin preparation of cardiac patients. AORN J 2002;76(5):821828.Google Scholar
172. Swenson, BR, Camp, TR, Mulloy, DP, Sawyer, RG. Antimicrobial-impregnated surgical incise drapes in the prevention of mesh infection after ventral hernia repair. Surg Infect (Larchmt) 2008; 9(1):2332.Google Scholar
173. Kaul, AF, Jewett, JF. Agents and techniques for disinfection of the skin. Surg Gynecol Obstet 1981;152(5):677685.Google Scholar
174. Webster, J, Osborne, S. Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev 2007;(2):CD004985.Google Scholar
175. Edmiston, CE Jr, Krepel, CJ, Seabrook, GR, Lewis, BD, Brown, KR, Towne, JB. Preoperative shower revisited: can high topical antiseptic levels be achieved on the skin surface before surgical admission? J Am Coll Surg 2008;207(2):233239.CrossRefGoogle ScholarPubMed
176. Eiselt, D. Presurgical skin preparation with a novel 2% chlorhexidine gluconate cloth reduces rates of surgical site infection in orthopaedic surgical patients. Orthop Nurs 2009;28(3):141145.Google Scholar
177. Segers, P, Speekenbrink, RG, Ubbink, DT, van Ogtrop, ML, de Mol, BA. Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate: a randomized controlled trial. JAMA 2006;296(20):24602466.Google Scholar
178. de Bruin, AF, Gosselink, MP, van der Harst, E, Rutten, HJ. Local application of gentamicin collagen implants in the prophylaxis of surgical site infections following gastrointestinal surgery: a review of clinical experience. Tech Coropractol 2010;14(4):301310.Google Scholar
179. Guzmán Valdivia Gomez, G, Guerrero, TS, Lluck, MC, Delgado, FJ. Effectiveness of collagen-gentamicin implant for treatment of “dirty” abdominal wounds. World J Surg 1999;23(2):123126.Google Scholar
180. Rutten, HJ, Nijhuis, PH. Prevention of wound infection in elective colorectal surgery by local application of a gentamicin-containing collagen sponge. Eur J Surg Suppl 1997;(578):3135.Google Scholar
181. Bennett-Guerrero, E, Pappas, TN, Koltun, WA, et al. Gentamicin-collagen sponge for infection prophylaxis in colorectal surgery. N Engl J Med 2010;363(11):10381049.Google Scholar
182. Eklund, AM, Valtonen, M, Werkkala, KA. Prophylaxis of sternal wound infections with gentamicin-collagen implant: randomized controlled study in cardiac surgery, J Hosp Infect 2005; 59(2):108112.Google Scholar
183. Friberg, O, Svedjeholm, R, Soderquist, B, Granfeldt, H, Vikerfors, T, Kallman, J. Local gentamicin reduces sternal wound infections after cardiac surgery: a randomized controlled trial. Ann Thome Surg 2005;79(1):153161.Google Scholar
184. Schimmer, C, Ozkur, M, Sinha, B, et al. Gentamicin-collagen sponge reduces sternal wound complications after heart surgery: a controlled, prospectively randomized, double-blind study, J Thorac Cardiovasc Surg 2012;143(1):194200.Google Scholar
185. Bennett-Guerrero, E, Ferguson, TB Jr, Lin, M, et al. Effect of an implantable gentamicin-collagen sponge on sternal wound infections following cardiac surgery: a randomized trial. JAMA 2010;304(7):755762.Google Scholar
186. Mavros, MN, Mitsikostas, PK, Alexiou, VG, Peppas, G, Falagas, ME. Gentamicin collagen sponges for the prevention of sternal wound infection: a meta-analysis of randomized controlled trials. J Thorac Cardiovasc Surg 2012;144(5):12351240.Google Scholar
187. Anthony, T, Murray, BW, Sum-Ping, JT, et al. Evaluating an evidence-based bundle for preventing surgical site infection: a randomized trial. Arch Surg 2011;146(3):263269.Google Scholar
188. Young-Xu, Y, Neily, J, Mills, PD, et al. Association between implementation of a medical team training program and surgical morbidity. Arch Surg 2011;146(12):13681373.Google Scholar
189. Malpiedi, PJ, Peterson, KD, Soe, MM, et al. 2011 National and State Healthcare-Associated Infection Standardized Infection Ratio Report. Atlanta: National Center for Emerging and Zoonotic Infectious Diseases, 2013. Accessed May 13, 2013.Google Scholar
190. Mu, Y, Edwards, JR, Horan, TC, Berrios-Torres, SI, Fridkin, SK. Improving risk-adjusted measures of surgical site infection for the national healthcare safety network. Infect Control Hosp Epidemiol 2011;32(10):970986.Google Scholar
191. Gaynes, RP, Solomon, S. Improving hospital-acquired infection rates: the CDC experience. Jt Comm J Qual Improv 1996;22(7): 457467.Google Scholar
192. Moehring, RW, Anderson, DJ. “But my patients are different!”: risk adjustment in 2012 and beyond. Infect Control Hosp Epidemiol 2011;32(10):987989.Google Scholar
193. Berrios-Torres, SI, Mu, Y, Edwards, JR, Horan, TC, Fridkin, SK. Improved risk adjustment in public reporting: coronary artery bypass graft surgical site infections. Infect Control Hosp Epidemiol 2012;33(5):463469.Google Scholar
194. Wong, ES, Rupp, ME, Mermel, L, et al. Public disclosure of healthcare-associated infections: the role of the Society for Healthcare Epidemiology of America. Infect Control Hosp Epidemiol 2005;26(2):210212.Google Scholar
195. McKibben, L, Horan, T, Tokars, JI, et al. Guidance on public reporting of healthcare-associated infections: recommendations of the Healthcare Infection Control Practices Advisory Committee. Am J Infect Control 2005;33(4):217226.Google Scholar
196. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and FY 2012 rates; hospitals’ FTE resident caps for graduate medical education payment. Final rules. Fed Regist 2011;76(160):5147651846.Google Scholar
197. Medicare program; hospital outpatient prospective payment system and CY 2007 payment rates; CY 2007 update to the ambulatory surgical center covered procedures list; Medicare administrative contractors; and reporting hospital quality data for FY 2008 inpatient prospective payment system annual payment update program—HCAHPS survey, SCIP, and mortality. Final rule with comment period and final rule. Fed Regist 2006; 71(226):6795968401.Google Scholar
198. National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Operational Guidance for Reporting Surgical Site Infection (SSI) Data to CDC’s NHSNfor the Purpose of CMS’s Fulfilling Hospital Inpatient Quality Reporting (IQR) Program Requirements. Atlanta: NCEZID, 2012. Accessed March 29, 2013.Google Scholar
199. Pronovost, PJ, Berenholtz, SM, Needham, DM. Translating evidence into practice: a model for large scale knowledge translation. BMJ 2008;337:a1714.Google Scholar
200. Wick, EC, Hobson, DB, Bennett, JL, et al. Implementation of a surgical comprehensive unit-based safety program to reduce surgical site infections. J Am Coll Surg 2012;215(2):193200.Google Scholar
201. Ritter, MA, French, ML, Eitzen, HE, Gioe, TJ. The antimicrobial effectiveness of operative-site preparative agents: a microbiological and clinical study. J Bone Joint Surg Am 1980;62(5):826828.Google Scholar
202. The Joint Commission. Joint Commission Center for Transforming Healthcare: Reducing Colorectal Surgical Site Infections. Oak-brook Terrace, IL: The Joint Commission, 2013. http://www Accessed August 19, 2013.Google Scholar
203. The Joint Commission. The Joint Commission’s Implementation Guide for NPSG.07.05.01 on Surgical Site Infections: SS The I Change Project. Oakbrook Terrace, IL: The Joint Commission, 2013. Accessed August 19, 2013.Google Scholar
204. Ballard, MR, Miller, NH, Nyquist, AC, Elise, B, Baulesh, DM, Erickson, MA. A multidisciplinary approach improves infection rates in pediatric spine surgery. J Pediatr Orthop 2012;32(3): 266270.Google Scholar
205. Cima, R, Dankbar, E, Lovely, J, et al. Colorectal surgery surgical site infection reduction program: a national surgical quality improvement program-driven multidisciplinary single-institution experience. J Am Coll Surg 2013;216(1):2333.Google Scholar
206. Hranjec, T, Swenson, BR, Sawyer, RG. Surgical site infection prevention: how we do it. Surg Infect (Larchmt) 2010;11(3): 289294.Google Scholar
207. Jain, M, Miller, L, Belt, D, King, D, Berwick, DM. Decline in ICU adverse events, nosocomial infections and cost through a quality improvement initiative focusing on teamwork and culture change. Qual Saf Health Care 2006;15(4):235239.Google Scholar
208. Alexander, JW, Solomkin, JS, Edwards, MJ. Updated recommendations for control of surgical site infections. Ann Surg 2011;253(6):10821093.Google Scholar
209. Hendren, S, Englesbe, MJ, Brooks, L, Kubus, J, Yin, H, Campbell, DA Jr. Prophylactic antibiotic practices for colectomy in Michigan. Am J Surg 2011;201(3):290293.Google Scholar
210. Riley, MM, Suda, D, Tabsh, K, Flood, A, Pegues, DA. Reduction of surgical site infections in low transverse cesarean section at a university hospital. Am J Infect Control 2012;40(9):820825.Google Scholar
211. Lipke, VL, Hyott, AS. Reducing surgical site infections by bundling multiple risk reduction strategies and active surveillance. AORN J 2010;92(3):288296.Google Scholar
212. Schwann, NM, Bretz, KA, Eid, S, et al. Point-of-care electronic prompts: an effective means of increasing compliance, demonstrating quality, and improving outcome. Anesth Analg 2011; 113(4):869876.Google Scholar
213. Berenguer, CM, Ochsner, MG Jr, Lord, SA, Senkowski, CK. Improving surgical site infections: using National Surgical Quality Improvement Program data to institute Surgical Care Improvement Project protocols in improving surgical outcomes. J Am Coll Surg 2010;210(5):737741.Google Scholar
214. Restie, JR, Riva-Cambrin, J, Wellons, JC 3rd, et al. A standardized protocol to reduce cerebrospinal fluid shunt infection: the Hydrocephalus Clinical Research Network Quality Improvement Initiative. J Neurosurg Pediatr 2011;8(1):2229.Google Scholar
215. Horan, TC, Gaynes, RP, Mattone, WJ, Jarvis, WR, Emori, TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13(10):606608.Google Scholar
216. Kaye, KS, Schmit, K, Pieper, C, et al. The effect of increasing age on the risk of surgical site infection. J Infect Dis 2005; 191(7):10561062.Google Scholar
217. Pessaux, P, Msika, S, Atalia, D, Hay, JM, Flamant, Y. Risk factors for postoperative infectious complications in noncolorectal abdominal surgery: a multivariate analysis based on a prospective multicenter study of 4718 patients. Arch Surg 2003;138(3):314324.Google Scholar
218. Raymond, DP, Pelletier, SJ, Crabtree, TD, Schulman, AM, Pruett, TL, Sawyer, RG. Surgical infection and the aging population. Am Surg 2001;67(9):827832.Google Scholar
219. Olsen, MA, Lefta, M, Dietz, JR, et al. Risk factors for surgical site infection after major breast operation. J Am Coll Surg 2008; 207(3):326335.Google Scholar
220. Faraday, N, Rock, P, Lin, EE, et al. Past history of skin infection and risk of surgical site infection after elective surgery. Ann Surg 2013;257(1):150154.Google Scholar
221. Forse, RA, Karam, B, MacLean, LD, Christou, NV. Antibiotic prophylaxis for surgery in morbidly obese patients. Surgery 1989;106(4):750756.Google Scholar
222. Hawn, MT, Houston, TK, Campagna, EJ, et al. The attributable risk of smoking on surgical complications. Ann Surg 2011; 254(6):914920.Google Scholar
223. Moller, AM, Pedersen, T, Villebro, N, Munksgaard, A. Effect of smoking on early complications after elective orthopaedic surgery. J Bone Joint Surg Br 2003;85(2):178181.Google Scholar
224. Moller, AM, Villebro, N, Pedersen, T, Tonnesen, H. Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet 2002;359(9301):114—117.Google Scholar
225. Sharma, A, Deeb, AP, Iannuzzi, JC, Rickles, AS, Monson, JR, Fleming, FJ. Tobacco smoking and postoperative outcomes after colorectal surgery. Ann Surg 2013;258(2):296300.Google Scholar
226. Theadom, A, Cropley, M. Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review. Tob Control 2006;15(5):352358.Google Scholar
227. Hennessey, DB, Burke, JP, Ni-Dhonochu, T, Shields, C, Winter, DC, Mealy, K. Preoperative hypoalbuminemia is an independent risk factor for the development of surgical site infection following gastrointestinal surgery: a multi-institutional study. Ann Surg 2010;252(2):325329.Google Scholar
228. Boyce, JM, Pittet, D; Society for Healthcare Epidemiology of America, Association for Professionals in Infection Control, Infectious Diseases Society of America. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR Recomm Rep 2002;51(RR-16)145.Google Scholar
229. Ford, CD, Van Moorleghem, G, Menlove, RL. Blood transfusions and postoperative wound infection. Surgery 1993;113(6):603607.Google Scholar
230. Horvath, KA, Acker, MA, Chang, H, et al. Blood transfusion and infection after cardiac surgery. Ann Thorac Surg 2013;95(6):21942201.Google Scholar
231. Olsen, MA, Lock-Buckley, P, Hopkins, D, Polish, LB, Sundt, TM, Fraser, VJ. The risk factors for deep and superficial chest surgical-site infections after coronary artery bypass graft surgery are different. J Thorac Cardiovasc Surg 2002;124(1):136145.Google Scholar
232. Facility Guidelines Institute (FGI) Guidelines. ANSI/ASHRAE/ASHE Standard 170: Ventilation of Health Care Facilities. Dallas: FGI, 2010. Accessed February 2, 2013.Google Scholar
233. Rutala, WA, Weber, DJ; Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. Atlanta: Centers for Disease Control and Prevention, 2008. Accessed December 1, 2013.Google Scholar
234. Guyatt, GH, Oxman, AD, Vist, GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924926.Google Scholar
235. GRADE. Canadian Task Force on Preventive Health Care website. Accessed December 31, 2013.Google Scholar