To reduce SSIs, all patients, not just diabetics, should have their blood glucose levels monitored and controlled during the perioperative process, says the American College of Surgeons, which recently released new and updated SSI-prevention guidance.
Calling the broadened recommendation the most notable change in the new guidelines, the ACS says the SSI risk for all patients can be lowered through "better short-term perioperative glucose control in the 110 to 150 mg/dL range."
The new guidelines also diverge from previous guidelines in recommending that antibiotics typically be discontinued once incisions are closed, instead of sometime over the following 24 hours.
There's no evidence, says the ACS, that antibiotic administration after incision closure decreases SSI risk across a range of procedures, including clean, clean-contaminated, and contaminated wound classes. However, there may be exceptions, it says, as optimal duration of antibiotic therapy remains unknown for total joints, implant-based breast reconstruction, and cardiac procedures.
The guidelines also say that better data is still needed in several areas, including surgical attire (but "conducting high-quality research in this area might not be feasible"), topical and local antibiotics and post-operative wound management.