Guidelines for the Prevention of Surgical Site Infection:
The Surgical Infection Society of Thailand
Recommendations (Executive Summary)
Lohsiriwat V, MD, PhD¹, Chinswangwatanakul V, MD, PhD¹, Lohsiriwat D, MD¹, Rongrungruang Y, MD²,
Malathum K, MD³, Ratanachai P, MD⁴, Butsripoom B, MS, PhD⁵, Asdornwised U, MS, PhD⁶, Boontham P, MD, PhD⁷,
on behalf of the Surgical Infection Society of Thailand
Affiliation : ¹ Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ² Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ³ Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ⁴ Department of Anesthesiology, Hatyai Hospital, Songkhla, Thailand ⁵ Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ⁶ Surgical Nursing Department, Faculty of Nursing, Mahidol University, Bangkok, Thailand ⁷ Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
Surgical site infection (SSI) is a common and potentially preventable complication after surgery. Recently there have been several
guidelines for preventing SSI published by a variety of organizations. To promote the prevention of incisional SSI, the Surgical
Infection Society of Thailand (SIST) systematically reviewed current evidence on this subject from the most recent studies
available, together with expert opinions on appropriate and suitable interventions in Thailand. The SIST Recommendations cover
four phases for a total of 28 items. They include pre-admission with three items, pre-operation with six items, intra-operation
with 15 items, and post-operation with four items. Of these recommendations, 10 items are Level 1 evidence or high level of
evidence and are grouped into “Thailand’s SSI Prevention Bundle”. This care bundle includes smoking cessation, weight-based
antibiotic prophylaxis, appropriate hair removal, skin preparation with alcohol-based solution, wound protectors for abdominal
surgery, antimicrobial-coated sutures for clean operation in high-risk patients and elective digestive surgery, perioperative glucose
control, intra-operative normothermia, peri-operative maintenance of oxygen saturation at least 92% or preferably at least 95%,
and changing contaminated gloves and surgical instruments before wound closure. Intravenous antibiotic prophylaxis suitable
for common operations in Thailand and their recommended dosing are noted in the SIST guidelines for the prevention of SSI.
Received 20 Nov 2019 | Revised 18 Dec 2019 | Accepted 20 Dec 2019
Keywords : Surgical site infection, Prevention, Guideline, Thailand, Antibiotic prophylaxis, Wound, Surgery, Operation, Bundle,
Recommendation
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