Surgical Infection Control: Evidence-Based Strategies for Prevention and Management
MTA
Protocols, antimicrobial stewardship, and perioperative decision-making to reduce surgical site infections
*Surgical Infection Control* provides a comprehensive, evidence-based framework for reducing surgical site infections (SSIs) by integrating clinical protocols, antimicrobial stewardship, and organizational reliability. The book establishes that SSIs are a multifaceted burdenācausing significant patient morbidity, mortality, and staggering healthcare costsābut notes that approximately 55% are preventable through disciplined adherence to perioperative strategies. It emphasizes that prevention begins long before the first incision, focusing on preoperative optimization of modifiable risk factors such as glycemic control, nutrition, and smoking cessation, as well as targeted screening and decolonization for pathogens like *Staphylococcus aureus*.
The core of the text details the precision required in the operating room, emphasizing the "right drug, right dose, and right timing" for antimicrobial prophylaxis. It provides nuanced guidance on managing beta-lactam allergies to avoid suboptimal alternatives and stresses the importance of weight-based dosing and intraoperative redosing. Beyond antibiotics, the book highlights the critical role of physiological optimizationāmaintaining normothermia, high tissue oxygenation, and stable blood glucose levelsāalongside meticulous surgical techniques, such as gentle tissue handling, effective hemostasis, and the strategic selection of monofilament sutures to minimize bacterial niches.
Specific attention is given to high-stakes procedures involving implants, such as orthopedic and cardiac surgeries, where the prevention of biofilms is paramount. In contaminated fields like colorectal surgery, the text advocates for a "triple-prep" approach combining mechanical cleansing with oral and intravenous antibiotics, as well as the use of wound protectors. Postoperatively, the book transitions to a strategy of vigilant surveillance and advanced wound care, including the use of prophylactic negative pressure wound therapy (NPWT) for high-risk incisions and the timely removal of indwelling devices like catheters and drains to close potential pathways for infection.
Ultimately, the book argues that sustained infection control is a system-level property rather than a series of isolated clinical acts. It champions the use of multidisciplinary antimicrobial stewardship teams, standardized bundles, and the WHO Surgical Safety Checklist to overcome human factors and ensure reliability. By utilizing quality improvement toolsāsuch as Statistical Process Control (SPC) charts for measurement and Root Cause Analysis (RCA) for system refinementāand adapting these protocols for ambulatory, resource-limited, and telehealth settings, the text provides a scalable roadmap for surgical teams to minimize waste and maximize patient safety.
This book is designed for surgical teams, including surgeons, anesthesiologists, perioperative nurses, and surgical technologists seeking to enhance patient safety. It is also an essential resource for hospital administrators, infection preventionists, and clinical pharmacists involved in quality improvement and antimicrobial stewardship. Additionally, healthcare providers in ambulatory and resource-limited settings will find valuable adaptations for diverse clinical environments.
January 14, 2026
English
76,712 words
5 hours 22 minutes
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