Prevention of perioperative infection

▶ Administration of preoperative antibiotics is associated with reduced rates of surgical site infections. ▶ Antibiotics should be continued for no longer than twenty-four hours after elective surgery or surgical treatment of closed fractures. ▶ Chlorhexidine gluconate is superior to povidone-iodine for preoperative antisepsis for the patient and surgeon. ▶ Closed suction drainage is not warranted in elective total joint replacement. It is associated with an increased relative risk of transfusions. Drains left in situ for more than twenty-four hours are at an increased risk for bacterial contamination. ▶ The rate of postoperative infections associated with occlusive dressings is lower than that associated with nonocclusive dressings. ▶ Appropriate management of blood glucose levels, oxygenation, and the temperature of the patient reduces the risk of postoperative infection.