New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective

Surgical site infections (SSIs) are the most common health-care-associated infections in developing countries, but they
also represent a substantial epidemiological burden in high-income countries. The prevention of these infections is
complex and requires the integration of a range of preventive measures before, during, and after surgery. No international
guidelines are available and inconsistencies in the interpretation of evidence and recommendations in national guidelines
have been identifi ed. Considering the prevention of SSIs as a priority for patient safety, WHO has developed evidencebased
and expert consensus-based recommendations on the basis of an extensive list of preventive measures. We present
in this Review 16 recommendations specifi c to the intraoperative and postoperative periods. The WHO recommendations
were developed with a global perspective and they take into account the balance between benefi ts and harms, the evidence
quality level, cost and resource use implications, and patient values and preferences.