The National Institute for Health and Clinical Excellence (NICE) has issued an updated clinical guideline on the prevention and treatment of surgical site infections in adults and children.

The key recommendations from the guideline include (taken directly from source):

• Patients and carers should be offered clear, consistent information and advice throughout all stages of their care. This should include the risks of surgical site infections, what is being done to reduce them and how they are managed.

Patients should be given antibiotic prophylaxis before clean surgery involving the placement of a prosthesis or implant, clean-contaminated surgery and contaminated surgery.

• Antibiotic prophylaxis should not be routinely used for clean non-prosthetic uncomplicated surgery.

• The patient’s skin should be prepared at the surgical site immediately before incision using an antiseptic (aqueous or alcohol-based) preparation with povidone-iodine or chlorhexidine being the most suitable.

• Hair removal should not be routinely used to reduce the risk of surgical site infection. However if hair has to be removed, single-use head electric clippers should be used on the day of surgery. Razors should not be used for hair removal, because they increase the risk of surgical site infection.

• At the end of the operation surgical incisions anticipated to heal by primary intention should be covered with a film membrane, with or without a central absorbent pad

• A tissue viability nurse (or another healthcare professional with wound care expertise) should also be referred to for advice on appropriate dressings for the management of surgical wounds that are healing from the base of the wound upwards (i.e. by secondary intention).

The guidance does not cover the following clinical scenarios:
• adults and children who are going to have an operation that does not involve a cut through the skin on the outside of the body
• adults and children who are going to have procedures involving catheters, shunts, endoscopes or metal pins used externally to treat broken bones.