From the Guidelines
Evidence-based practice supports increased personal hygiene and frequent linen changes as effective measures in preventing surgical site infections (SSIs). The most recent and highest quality study, 1, recommends preoperative skin antiseptics, removal of nail polish and finger rings, and preoperative bathing or showering with skin antiseptics to prevent wound infection.
Key Recommendations
- Preoperative bathing or showering with antiseptic agents like chlorhexidine gluconate (CHG) to reduce SSIs, as supported by 1
- Daily CHG bathing for hospitalized patients postoperatively, along with regular linen changes (at least daily or when soiled) to reduce bacterial load in the patient's environment, as suggested by 1
- Proper hand hygiene by both patients and healthcare providers before and after wound care, as emphasized by 1
- Surgical site care should follow specific protocols, including keeping the incision clean and dry for 24-48 hours post-surgery and changing dressings using sterile technique, as recommended by 1
Rationale
These measures are effective because they reduce the bacterial burden on the skin and in the patient's immediate environment, decreasing the risk of pathogens entering the surgical wound. The combination of antiseptic bathing, clean linens, and proper hand hygiene creates multiple barriers against infection during the vulnerable healing period.
Additional Considerations
- A comprehensive approach to infections across the surgical pathway, as proposed by 1, is essential for preventing SSIs
- Implementation of a care bundle, including topical intranasal therapies, weight-based cephalosporin infusion, skin preparation, and depilation protocols, can reduce SSIs, as recommended by 1
- Regular linen changes and proper hand hygiene are crucial in reducing the bacterial load in the patient's environment, as supported by 1 and 1
From the Research
Effectiveness of Increased Personal Hygiene and Frequent Linen Changes
- There is no direct evidence in the provided studies that specifically addresses the effectiveness of increased personal hygiene and frequent linen changes in preventing surgical site infections (SSIs) 2, 3, 4, 5, 6.
- However, the studies emphasize the importance of evidence-based practices in preventing SSIs, including hand hygiene, preoperative patient skin antisepsis, and antimicrobial irrigation 4.
- The World Health Organization (WHO) has developed evidence-based recommendations for the prevention of SSIs, which include preoperative measures such as hand hygiene and patient skin preparation 3.
- Other strategies for preventing SSIs include antimicrobial prophylaxis, optimization of patient factors, and use of evidence-based pharmacologic and nonpharmacologic measures 5, 6.
- Perioperative nurses play a crucial role in preventing SSIs by employing evidence-based best practices, including hand hygiene, preoperative patient skin antisepsis, and antimicrobial irrigation 4.