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Table 2 SSI prevention bundle elements

From: American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery

Phase of care Element
Preoperative at home Smoking cessation
Preoperative at home Diabetes optimization (check and treat HbA1c)
Preoperative at home Anemia optimization (folate, iron, vitamin C, Venofer)
Preoperative at home Chlorhexidine showers
Preoperative at hospital Clipping (not shaving) surgical site
Preoperative at hospital Chlorhexidine towelettes
Intraoperative Active warming to prevent hypothermia
Intraoperative Appropriate (selection, dose, timing) IV antibiotic within 60 min of incision, discontinued within 24 h
Intraoperative Routine use of a wound protector
Intraoperative Routine use alcohol-containing skin prep
Intraoperative Routine intra-op high-concentration supplemental oxygen
Intraoperative Reduce unnecessary traffic in the operating room
Intraoperative Routine use of separate fascial closure tray or separate anastomotic tray
Global Adherence to hand hygiene
Global Active surveillance program with education, compliance, and feedback
Global Optimize preoperative glucose control, Maintain blood glucose <180 through POD 2
  1. SHEA/IDSA practice recommendations 2014 (Causey et al. 2011). Note most institutions surgical sub-specialties develop their own bundles to address local issues by selecting a sub-set of the menu of elements listed