Updated Recommendations for Control of Surgical Site Infections

J. Wesley Alexander, MD, ScD; Joseph S. Solomkin, MD; Michael J. Edwards, MD


Annals of Surgery. 2011;253(6):1082-1093. 

In This Article

Tissue Damage and Foreign Bodies

Because the elaboration of Halstedian principles a century ago, there has been little debate that excessive tissue injury and introduction of foreign materials increase the incidence of wound infections. The use of electrocautery for opening of wounds is used frequently although there is clear evidence that it may increase the incidence of infection (SDC-79-80). The expert consensus is that if electrocautery is to be used, it should be used primarily for pinpoint treatment of bleeders and not for all incisions. (An exception might be made in the presence of coagulopathy).

Techniques that involve obliteration of all potential dead spaces by multilayered closures are effective in preventing wound infections in contaminated areas (SDC-81-82).


Surgical technique is one of the primary factors in preventing wound infection. Poor surgical technique cannot be overridden by the use of antibiotics or any other method.


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