(see comment below)
Global guidelines on the prevention of surgical site infection
Publication date: First edition, November 2016; second edition, December 2018
Free download: https://www.who.int/infection-prevention/publications/implementation-man...
'Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US$ 10 billion per year. These WHO guidelines which were updated in 2018, are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences'
Comment (NPW): As the text notes: 'Surgical site infections contribute to the threat of antimicrobial resistance (AMR)... IPC plays a critical role in reducing both the spread of antibiotic-resistant organisms and the occurrence of infections; it also promotes the appropriate use of antibiotics.' As AMR increases, so too will death from untreatable surgical infections. This will be particularly catastrophic in LMICs where infection rates are high. Of course, it is even more vital to reduce surgical site infection rates in the first place, as shown through these guidelines.
As a further comment, I would be interested to hear from the authors of this 2nd edition about how they may have used feedback on the 1st edition to guide the content and presentation of the guidelines. Have any HIFA members reviewed the 1st or 2nd editions and would like to comment? (More generally, could HIFA be used as a way to solicit feedback on WHO publications?) To what extent are the guidelines intended for direct use at facility level versus adaptation and integration into national policy guidelines? Do the guidelines provide adequate information for low-resource settings?
Best wishes, Neil
Coordinator, HIFA Project on Evidence-Informed Policy and Practice
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