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National Collaborating Centre for Women's and Children's Health (UK). Surgical Site Infection: Prevention and Treatment of Surgical Site Infection. London: RCOG Press; 2008 Oct. (NICE Clinical Guidelines, No. 74.)

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  • Update information: August 2020: In the recommendations on maintaining patient homeostasis NICE added a link to the NICE guideline on perioperative care in adults to highlight additional guidance on intravenous fluids, cardiac monitoring and blood glucose control for adults. August 2019: Footnotes to table 1 on options for antiseptic skin preparation were updated. April 2019: NICE reviewed the evidence and made new recommendations on nasal decolonisation, preoperative antiseptic skin preparation, antiseptics and antimicrobials before wound closure, and methods of wound closure to prevent surgical site infections in people having surgery. These recommendations are marked [2019] in the pdf. Recommendations marked [2008] in the pdf last had an evidence review in 2008. In some cases, minor changes have been made in the pdf to the wording to bring the language and style up to date, without changing the meaning. Evidence reviews and committee discussions from the 2019 update are contained in standalone documents - see www.nice.org.uk/guidance/ng125/evidence This document preserves evidence reviews and committee discussions for areas of the guideline that were not updated in 2019. The pdf has been colour coded as follows: • All text without shading is from the original 2008 guideline and has not been amended by subsequent updates. • Black shading indicates text from 2008 has been replaced by the 2019 update. June 2019: Hydrex Surgical Scrub was added to footnote 2 of table 1. All these changes can be seen in the short version of the guideline at www.nice.org.uk/guidance/ng125

Update information: August 2020: In the recommendations on maintaining patient homeostasis NICE added a link to the NICE guideline on perioperative care in adults to highlight additional guidance on intravenous fluids, cardiac monitoring and blood glucose control for adults. August 2019: Footnotes to table 1 on options for antiseptic skin preparation were updated. April 2019: NICE reviewed the evidence and made new recommendations on nasal decolonisation, preoperative antiseptic skin preparation, antiseptics and antimicrobials before wound closure, and methods of wound closure to prevent surgical site infections in people having surgery. These recommendations are marked [2019] in the pdf. Recommendations marked [2008] in the pdf last had an evidence review in 2008. In some cases, minor changes have been made in the pdf to the wording to bring the language and style up to date, without changing the meaning. Evidence reviews and committee discussions from the 2019 update are contained in standalone documents - see www.nice.org.uk/guidance/ng125/evidence This document preserves evidence reviews and committee discussions for areas of the guideline that were not updated in 2019. The pdf has been colour coded as follows: • All text without shading is from the original 2008 guideline and has not been amended by subsequent updates. • Black shading indicates text from 2008 has been replaced by the 2019 update. June 2019: Hydrex Surgical Scrub was added to footnote 2 of table 1. All these changes can be seen in the short version of the guideline at www.nice.org.uk/guidance/ng125

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Surgical Site Infection: Prevention and Treatment of Surgical Site Infection.

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Appendix IPostoperative cleansing of the wound

Observations of current clinical practice would suggest that the majority of healthcare practitioners continue to use sterile normal saline for the cleansing of acute (for example, surgical) wounds, while tap water is normally reserved for the cleansing of chronic wounds or for the initial cleansing of traumatic injuries while in the accident and emergency department.

The reasons for cleansing surgical wounds (not dry surgical incision sites) and the surrounding wound areas on a regular basis are generally accepted as being for the:

  • removal of excess wound exudates (reducing the risk/effects of both excoriation and maceration)
  • removal of ‘mobile’ slough
  • removal of foreign bodies, including residues from other wound management products
  • removal of wound crusts (generally these are made up of a combination of fibrin, dehydrated exudates and dressing residue, and are most likely to be found at the wound edge)
  • psychological wellbeing of the patient.

Issues of source and quality of tap water used as a wound cleansing solution need to be carefully considered, as although it is acknowledged that hospital tap water can be delivered at a constant temperature (having firstly gone through a process ensuring that all harmful bacteria have been killed) the same cannot be said for tap water within the homes of patients.

Copyright © 2008, National Collaborating Centre for Women’s and Children’s Health.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK [www.cla.co.uk]. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

Bookshelf ID: NBK53717
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