Table 1 Risk factors for SSIs

Preoperative risk factors

1. Unmodifiable

a. Increasing age until age 65 years

b. Recent radiotherapy and history of skin or soft tissue infection

2. Modifiable

a. Uncontrolled diabetes

b. Obesity, malnutrition

c. Current smoking

d. Immunosuppression

e. Preoperative albumin < 3.5 mg/dL

f. Total bilirubin > 1.0 mg/d

g. Preoperative hospital stay of at least 2 days

Perioperative risk factors

1. Procedure-related

a. Emergency and more complex surgery,

b. Higher wound classification

c. Open surgery.

2. Facility risk factors

a. Inadequate ventilation,

b. Increased operation theatre traffic

c. Inappropriate/inadequate sterilization of instruments/equipment.

3. Patient preparation-related

a. A pre-existing infection

b. Inadequate antiseptic skin preparation

c. Preoperative hair removal

d. Wrong antibiotic choice, administration, and/or duration

4. Intraoperative risk factors

a. Long operating time

b. Blood transfusion

c. Asepsis and surgical technique

d. Hand/forearm antisepsis and gloving techniques

e. Hypoxia

f. Hypothermia

g. Poor glycaemic control.

Postoperative risk factors

1. Hyperglycaemia and diabetes

2. Postoperative wound care

3. Transfusion