The National Institute for Health and Care Excellence (NICE) has issued standards to help prevent and treat surgical site infection in adults, children and young people undergoing surgical incisions through the skin.

Surgical site infection is a type of healthcare-associated infection in which a surgical incision site becomes infected after a surgical procedure. Surgical site infections have been shown to account for up to 16% of all healthcare-associated infections. The rate of surgical site infection varies depending on the type of procedure, with rates of over 10% for large bowel surgery, and less than 1% for orthopaedic procedures. Surgical site infections can often be prevented with appropriate care before, during and after surgery. If an infection does develop, the correct treatment will minimise complications resulting from the infection.

The NICE quality standard is based on the NICE guidance on both surgical site infection and healthcare- associated infections.

In summary:

• People having surgery should not remove hair from the surgical site, because it may increase the risk of infection. If hair needs to be removed, this should be done by healthcare staff using electric clippers with a single-use head on the day of surgery. People having surgery are also advised to have (or are helped to have) a shower, bath or bed bath the day before or on the day of surgery to reduce the number of microorganisms on the skin surrounding the incision.
• Appropriate wound and dressing care promotes healing and reduces the risk of infection. People having surgery and their carers should receive information and advice on wound and dressing care, including how to recognise problems with the wound and who to contact if they are concerned.
• People having surgery should be cared for by healthcare providers that monitor surgical site infection rates (including post-discharge infections), and provide feedback to relevant staff and stakeholders to enable continuous improvement through interventions and adjustment of clinical practice.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: "Serious surgical site infections can lead to life-threatening illnesses, long-term disabilities, and longer stays in hospital as well as resulting in increased costs for the NHS. However, such infections can often be prevented by following simple steps before, during and after surgery. These standards will aid all healthcare professionals involved in the treatment of adults, children and young people in this area, so that they can deliver the very best levels of care across the NHS."

Dr Peter Jenks, Director of Infection Prevention and Control/Consultant Microbiologist, Plymouth Hospitals NHS Foundation Trust and chair of the topic expert group which developed the quality standard said: "As well as resulting in substantial discomfort and harm to patients who have undergone operations, surgical site infections contribute to the burden on healthcare service providers by prolonging hospital stay and increasing costs. With the clinical imperative of eliminating all preventable healthcare-associated infections, these quality standards will assist providers, commissioners and patients in improving outcomes following surgical procedures."

The NICE quality standard for surgical site infection is available on the NICE website from 00:01hrs on Thursday 31 October.

Ends

Notes to Editors

About the quality standard

1. The NICE quality standard for surgical site infection is available on the NICE website from 00:01hrs on Thursday 31 October.

2. The NICE quality standard for surgical site infection is based on the following NICE accredited guidelines:

• Prevention and control of healthcare-associated infections. NICE public health guidance 36 (2011)
• Surgical site infection. NICE clinical guideline 74 (2008)
• Inadvertent perioperative hypothermia. NICE clinical guideline 65 (2008)

3. NICE quality standards describe high-priority areas for quality improvement in a defined care or service area. They are derived either from NICE guidance or guidance from other sources that have been accredited by NICE, and apply right across the NHS in England.

Related NICE quality standards

Published

• Patient experience in adult NHS services. NICE quality standard 15 (2012)
• Infection control. Publication expected April 2014

Future quality standards

This quality standard has been developed in the context of all quality standards referred to NICE, including the following topics scheduled for future development:

• perioperative care
• readmissions
• sepsis.

About NICE quality standards

NICE quality standards aim to help commissioners, health care professionals, social care and public health practitioners and service providers improve the quality of care that they deliver.

NICE quality standards are prioritised statements designed to drive measurable quality improvements within a particular area of health or care. There is an average of 6-8 statements in each quality standard.

Quality standards are derived from high quality evidence-based guidance, such as NICE guidance or guidance from NICE accredited sources, and are produced collaboratively with health care professionals, social care and public health practitioners, along with their partner organisations, patients, carers and service users.

NICE quality standards are not mandatory but they can be used for a wide range of purposes both locally and nationally. For example, patients and service users can use quality standards to help understand what high-quality care should include. Health care professionals and social care and public health practitioners can use quality standards to help deliver high quality care and treatment.

NICE quality standards are not requirements or targets, but the health and social care system is obliged to have regard to them in planning and delivering services, as part of a general duty to secure continuous improvement in quality.

Quality standard topics are formally referred to NICE by NHS England (an executive non-departmental public body, established in October 2012) for health-related areas, and by the Department of Health and Department for Education for areas such as social care and public health.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Formerly the National Institute for Health and Clinical Excellence, our name changed on 1 April 2013 to reflect our new and additional responsibility to develop guidance and set quality standards for social care, as outlined in the Health and Social Care Act (2012).

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

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