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Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017

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Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017 Supplementary Online Content Berríos-Torres SI, Umscheid CA, Bratzler DW, et al; Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. Published online May 3, 2017. doi:10.1001/jamasurg.2017.0904 eAppendix 1. Centers for Disease Control and Prevention, Guideline for the Prevention of Surgical Site Infection 2017 –Background, Methods and Evidence Summaries eAppendix 2. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017: Supplemental Tables This supplementary material has been provided by the authors to give readers additional information about their work. © 2017 American Medical Association. All rights reserved. 1 Downloaded From: https://jamanetwork.com/ on 09/30/2021 eAppendix 1. Centers for Disease Control and Prevention, Guideline for the Prevention of Surgical Site Infection 2017: Background, Methods and Evidence Summaries TABLE OF CONTENTS 1. BACKGROUND ........................................................................................................................................................................................................................................................... 4 1.1. Prosthetic Joint Arthroplasty ................................................................................................................................................................................................................................. 4 2. SCOPE AND PURPOSE .............................................................................................................................................................................................................................................. 5 3. METHODS ................................................................................................................................................................................................................................................................... 5 3.1Guideline Questions ................................................................................................................................................................................................................................................ 5 3.1A. CORE SECTION GUIDELINE QUESTIONS .............................................................................................................................................................................................. 6 3.1B. PROSTHETIC JOINT ARTHROPLASTY SECTION GUIDELINE QUESTIONS .................................................................................................................................... 6 3.2. Literature Search ................................................................................................................................................................................................................................................... 7 3.3. Study Selection ...................................................................................................................................................................................................................................................... 8 3.4. Data Extraction and Synthesis ............................................................................................................................................................................................................................. 11 3.5. Formulating Recommendations ........................................................................................................................................................................................................................... 11 4. EVIDENCE REVIEW ................................................................................................................................................................................................................................................ 13 4.1. Core Section Evidence Review ........................................................................................................................................................................................................................... 13 4.1A. PARENTERAL ANTIMICROBIAL PROPHYLAXIS (AMP) .................................................................................................................................................................. 13 4.1B. NON-PARENTERAL ANTIMICROBIAL PROPHYLAXIS ..................................................................................................................................................................... 16 4.1C. GLYCEMIC CONTROL ............................................................................................................................................................................................................................. 20 4.1D. NORMOTHERMIA .................................................................................................................................................................................................................................... 21 4.1E. OXYGENATION ......................................................................................................................................................................................................................................... 22 4.1F. ANTISEPTIC PROPHYLAXIS ................................................................................................................................................................................................................... 25 4.2. Prosthetic Joint Arthroplasty Section Evidence Review ..................................................................................................................................................................................... 30 4.2A. BLOOD TRANSFUSION ........................................................................................................................................................................................................................... 30 4.2B. SYSTEMIC IMMUNOSUPPRESSIVE THERAPY ................................................................................................................................................................................... 32 4.2C. INTRA-ARTICULAR CORTICOSTEROID INJECTIONS ....................................................................................................................................................................... 34 4.2D. ANTICOAGULATION ............................................................................................................................................................................................................................... 36 4.2E. ORTHOPAEDIC SURGICAL SPACE SUIT .............................................................................................................................................................................................. 38 4.2F. POSTOPERATIVE AMP DURATION IN PROSTHETIC JOINT ARTHROPLASTY WITH THE USE OF A DRAIN ........................................................................ 39 4.2G. BIOFILM ..................................................................................................................................................................................................................................................... 39 5. RE-EMPHASIS OF SELECT 1999 CDC AND HICPAC RECOMMENDATIONS FOR PREVENTION OF SURGICAL SITE INFECTIONS ................................................. 41 5.1. Recommendations ............................................................................................................................................................................................................................................... 41 © 2017 American Medical Association. All rights reserved. 2 Downloaded From: https://jamanetwork.com/ on 09/30/2021 1. PREPARATION OF THE PATIENT ........................................................................................................................................................................................................... 41 2. HAND/FOREARM ANTISEPSIS FOR SURGICAL TEAM....................................................................................................................................................................... 41 3. OPERATING ROOM VENTILATION ........................................................................................................................................................................................................ 41 4. CLEANING AND DISINFECTION OF ENVIRONMENTAL SURFACES .............................................................................................................................................. 41 5. REPROCESSING OF SURGICAL INSTRUMENTS .................................................................................................................................................................................. 41 6. SURGICAL ATTIRE AND DRAPES .......................................................................................................................................................................................................... 41 7. STERILE AND SURGICAL TECHNIQUE ................................................................................................................................................................................................
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