Estimates suggest one in 20 patients develop an infection following surgery, costing the NHS around £1bn each year (SSHAIP 2004). This article discusses surgical site infections and the commonest bacteria which cause them. It then explores two practices, preoperative body washing and preoperative hair removal, and their effect on bacterial reduction and surgical site infection.
Association for Perioperative Practice2007Standards and Recommendations for Safe Perioperative PracticeHarrogate, AfPP
2.
AlexanderW.J., FischerJ.E., BoyajianM., PalmquistJ., MorrisM.J.1983The influence of hair removal methods on wound infectionsArchives of Surgery118(3) 347–352
3.
Association of Perioperative Registered Nurses2006Standards, Recommended Practices and GuidelinesDenver, AORN
4.
AyliffeG.A., NoyM.F., BabbJ.R.1983A comparison of preoperative bathing with chlorhexidine-detergent and non-medicated soap in the prevention of wound infectionJournal of Hospital Infection4(3) 237–244
5.
BergmanB.R., SeebergS.1979A bacteriological evaluation of a programme for preoperative total body-washing with chlorhexidine gluconate performed by patients undergoing orthopaedic surgeryArchives of Orthopaedic Trauma Surgery94(1) 59–62
6.
BrandbergA., AnderssonI.1979Whole body disinfection by shower-bath with chlorhexidine soapThe Royal Society of Medicine International Congress and Symposium Vol 23 The Royal London, Society of Medicine and Academic Press pp 65–70
7.
BrandbergA., HolmJ., HammarstenJ., ScherstenT.1979Post-operative wound infections in vascular surgery - effect of preoperative whole body disinfection by shower-bath with chlorhexidine soapThe Royal Society of Medicine International Congress and Symposium Vol 23London, The Royal Society of Medicine and Academic Press pp 71–75
8.
BriggsM.1997Principles of closed surgical wound careJournal of Wound Care6(6) 288–292
9.
Centers for Disease Control1999Guidelines for prevention of surgical site infection 1999Infection Control and Hospital Epidemiology20(4) 247–278
10.
CulverD.H., HoranT.C., GaynesR.P.1991Surgical wound infection rates by wound class, operative procedure, and patient risk index National Nosocomial Infections Surveillance SystemAmerican Journal of Medicine91(3B) 152S–157S
11.
Department of Health2006Hospital episode statistics. Main operation: summary tables 2005/6 Available from: www.hesonline.nhs.uk [Accessed January 2008]
12.
Department of Health2007Summary of the preliminary results of third prevalence survey of healthcare-associated infections in acute hospitals 2006 Available from: www.dh.gov.uk [Accessed January 2008]
13.
EarnshawJ.J., BerridgeD.C., SlackR.C.1989Do preoperative chlorhexidine baths reduce the risk of infection after vascular reconstruction?European Journal of Vascular Surgery3(4) 323–326
14.
FoggD.1999Infection Control. In: MeekerM.H., RothrockJ.C. (eds) Alexander's Care of the Patient in SurgerySt Louis, Mosby
HayekL.J., EmersonJ.M., GardnerA.M.1987A placebo-controlled trial of the effect of two preoperative baths or showers with chlorhexidine detergent on postoperative wound infection ratesJournal of Hospital Infection10(2) 165–172
17.
Health Protection Agency2006Surveillance of Surgical Site Infection in England: October 1997-September 2005London, Health Protection Agency
18.
Health Protection Agency2007Antimicrobial Resistance in England, Wales and Northern Ireland, 2006London, Health Protection Agency
19.
KirklandK.B., BriggsJ.P., TrivetteS.L.1999The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costsInfection Control in Hospital Epidemiology20(11) 725–730
20.
LeighD.A., StrongeJL, MarrinerJ, SedgwickJ.1983Total body bathing with ‘Hibiscrub’ (chlorhexidine) in surgical patients: a controlled trialJournal of Hospital Infection4(3) 229–235
21.
LynchW., DaveyP.G., MalekM.1992Cost-effectiveness analysis of the use of chlorhexidine detergent in preoperative whole-body disinfection in wound infection prophylaxisJournal of Hospital Infection21(3) 179–191
22.
MewsP.A.2000Establishing and maintaining a sterile field. In: PhippenM.L., WellsM.P. (eds) Patient care during operative and invasive proceduresPhiladelphia, WB Saunders
23.
National Audit Office2004Improving patient care by reducing the risk of hospital acquired infection: A progress report. Report by the Comptroller and Auditor General. HC 876 Session 2003–2004London, The Stationery Office
24.
National Nosocomial Infections Surveillance2001Surveillance of surgical site infection in English Hospitals 1997–2001London, Public Health Laboratory Service
25.
National Nosocomial Infections Surveillance2002National Nosocomial Infections Surveillance System reportAmerican Journal of Infection Control30(8) 458–475
26.
NixonM., JacksonB., VargheseP., JenkinsD., TaylorG.2006Methicillin-resistant Staphylococcus aureus on orthopaedic wardsJournal of Bone and Joint Surgery88(6) 812–817
27.
PatersonD.L.2006Resistance in gram negative bacteriaAmerican Journal of Medicine119(6) S20–28
28.
PetherickE.S., DaltonJ.E., MooreP.J., CullumN.2006Methods for identifying surgical wound infection after discharge from hospital: a systematic reviewBMC Infectious Diseases6:170 doi:10.1186/1471-2334-6-170
29.
RandallP.E., GanguliL., MarcusonR.W.1983Wound infection following vasectomyBritish Journal of Urology55(5) 564–567
RiceL.B.2001Emergence of vancomycin resistant enterococciEmerging Infectious Diseases7(2) 183–187
32.
RotterM.L., LarsenS.O., CookeE.M.1988A comparison of the effects of preoperative whole-body bathing with detergent alone and with detergent containing chlorhexidine gluconateon the frequency of wound infections after clean surgery. The European Working Party on Control of Hospital InfectionsJournal of Hospital Infection11(4) 310–320
33.
Scottish Surveillance of Healthcare Associated Infection Programme2004Surveillance of surgical site infection for procedures carried out from 1/04/02-30/06/03Scotland, Scottish Centre for Infection and Environmental Health
34.
TammelinA., HambraeusA., StahleE.2001Source and route of methicillin-resistant Staphylococcus epidermidis transmitted to the surgical wound during cardio-thoracic surgery. Possibility of preventing wound contamination by use of special scrub suitsJournal of Hospital Infection47(4) 266–276
35.
TannerJ., WoodingsD., MoncasterK.2006Preoperative hair removal to reduce surgical site infectionsThe Cochrane Database of Systematic Reviews Issue 3
36.
van den BerghM.F.Q., YzermanE.P.F., van BelkumA, BoelensH.A.M., SijmonsM., VerbrughH.A.1999Follow up of Staphylococcus aureus nasal carriage after 8 yearsJournal of Clinical Microbiology37(10) 3133–3140
37.
WebsterJ., OsborneS.2007Preoperative bathing or showering with skin antiseptics to prevent surgical site infectionThe Cochrane Database of Systematic Reviews Issue 4
38.
WellsF.C., NewsomS.W., RowlandsC.1983Wound infection in cardiothoracic surgeryThe Lancet1(8335) 1209–1210
39.
WhitehouseJ.D., FriedmanN.D., KirklandK.B.2002The 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 costInfection Control in Hospital Epidemiology23(4) 183–189
40.
WhyteW., HambraeusA., LaurellG., HobornJ.1999The relative importance of routes and sources of wound contamination during general surgeryJournal of Hospital Infection18(2) 93–107
