COMPARATIVE EFFECTIVENESS OF SURGICAL SITE INFECTION PREVENTION PROTOCOLS: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.56238/levv16n53-136Keywords:
Surgical Wound Infection, Infection Control, Perioperative Care, Antibiotic ProphylaxisAbstract
Introduction: Surgical site infections (SSIs) remain among the most frequent and costly postoperative complications worldwide. Despite technological advances, their prevention continues to challenge surgical teams, with rates varying by procedure type, institution, and adherence to standardized bundles. Evidence-based protocols integrating antimicrobial prophylaxis, antiseptic preparation, intraoperative normothermia, and postoperative wound care have shown variable success depending on implementation fidelity and patient factors.
Objective: The primary objective of this systematic review was to evaluate and compare the effectiveness of multimodal SSI prevention protocols across surgical specialties. Secondary objectives included identifying which combinations of preventive measures most significantly reduce infection incidence, assessing adherence-related outcomes, and determining the quality of evidence supporting current international recommendations.
Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP databases. Inclusion criteria encompassed randomized controlled trials, cohort studies, and meta-analyses published between 2015 and 2025 evaluating SSI prevention protocols in adult surgical populations. Studies without standardized protocols or lacking infection rate outcomes were excluded. Data were synthesized narratively following PRISMA guidelines, and study quality was assessed using GRADE criteria.
Results and Discussion: From 1,842 records identified, 27 studies met inclusion criteria. Multimodal SSI prevention bundles combining perioperative antibiotic prophylaxis, chlorhexidine-alcohol skin antisepsis, glycemic control, and normothermia maintenance consistently reduced infection rates compared to single-measure protocols. Evidence also indicated that protocol adherence and timing of prophylaxis were critical determinants of efficacy. Robotic and minimally invasive surgeries exhibited lower SSI risk but still benefited from standard preventive bundles.
Conclusion: Comprehensive, evidence-based SSI prevention protocols significantly reduce postoperative infections across surgical disciplines. Optimal results depend on multidisciplinary adherence, timely antibiotic administration, and standardized perioperative care. Hospitals should prioritize continuous staff education and surveillance programs to sustain long-term reductions in SSI incidence.
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References
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