Tools for Surgical Site Infection Prevention

Prevention of surgical site infections (SSIs) is even more important than ever now that the Centers for Medicare & Medicaid Services (CMS) is no longer reimbursing healthcare facilities for SSIs regarding several operations. These include SSIs following coronary artery bypass graft, certain orthopedic procedures, and bariatric surgery.¹ Saving lives is the No. 1 goal, but saving money is important too, and any healthcare worker who wants to improve the financial landscape of their facility will do as much as possible to reduce SSIs.

Skin Antisepsis

Proper skin antisepsis is one of the cheapest and most simple ways to reduce risk of SSI. Surgeons and their staffs take skin preparation “very seriously,” says Kelly Manning, RN, BSN, CIC, of the infection control department at Community Health Network in Indianapolis.

However, she adds: “I think sometimes it is hard to change what you have always done (Betadine scrub, shaving). Surgeons are creatures of habit and many are very ritualistic regarding their technique, thus the resistance to change. From my experience, having a surgeon champion that is well respected by other surgeons is the key to moving beyond what you have always done. Physicians respond well to data and literature that supports change and are generally willing to change their practice if it is clear that it is in the best interest of the patient.”

Surgeons and their staffs take skin antisepsis of their patients seriously, according to Robert Sawyer, MD, associate professor and co-director of the Surgical Trauma Intensive Care Unit in Charlottesville, Va. However, preparation of staff skin is sometimes a different story, he believes.

“Preparation of the surgeon’s or staff’s skin is taken less seriously, probably because the evidence is less compelling on how to do it well — scrub for two minutes versus five minutes versus alcohol rubs,” Sawyer says.