Surgical site infections (SSIs) are now the most common and
costly healthcare-associated infection (HAI) in the United States.1
They are believed to account for up to $3.5 billion annually in
excess healthcare expenditures2 and remain a significant cause of
morbidity and mortality among hospitalized patients. However,
recent estimates suggest that as many as 55 percent of SSIs could
be prevented with current evidence-based strategies3 designed to
reduce the risk of infection.
Understanding Key Risk Factors
SSIs occur when surgical sites encounter microbial contamination; therefore, prevention methods should focus on reducing the presence and limiting the spread
of microorganisms. With this in mind, it is important to consider the following risk
1. Host factors: patient characteristics such as length of preoperative stay, comor-bidities and colonization with microorganisms
2. Microbial factors: characteristics such as virulence, antibiotic resistance and
3. Surgical/environmental factors: operation characteristics such as perioperative care, surgical technique and intraoperative contamination
The Skin and Surface Approach
For the majority of SSIs, the primary source of contamination is the patient’s skin, so it
comes as no surprise that patient skin preparation and the use of an appropriate antiseptic agent to perform preoperative surgical scrub are among the key recommendations to address patient risk factors included in the“Compendium of Strategies
to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update,” led by the
Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases
Society of America (IDSA). The new guideline also suggests that providing patients
with instructions and information on reducing infection risk prior to surgery is a key
SSI prevention strategy recommended for all acute care hospitals.
Patient compliance is an important component of any skin cleansing program. The
Clorox Healthcare™ 4% Chlorhexidine Gluconate (CHG) Skin Cleansing Kit is an easy-to-use kit for reducing bacteria on the skin prior to surgery. Two single-use packs, attached
via a perforated seal, contain the essentials for at least one pre-procedural CHG shower,
consistent with recommendations of the Association of periOperative Registered
Nurses (AORN) and the Centers for Disease Control and Prevention (CDC). The kit
also removes barriers to correct product usage by giving patients everything they need in one convenient
package, including a bilingual, waterproof instruction
card with illustrations and text that can be
taken into the shower for easy reference.
Optimal cleaning and disinfection of
equipment and surfaces in the operating room
(OR) environment is another essential feature
of recommended strategies to prevent SSIs.
Following surgical procedures, surfaces in the
OR environment can become contam-
inated with infectious waste and
quick turnaround time between
procedures is critical. Clorox
Peroxide Cleaner Disinfec-
tants clean and disinfect
in one step, cutting down the time
it takes to effectively address blood and
bodily fluids in the OR. The products, which
are Environmental Protection Agency
(EPA)-registered to kill many of the micro-
organisms that cause SSIs, are effective
against blood-borne pathogens and
come in ready-to-use wipes.
In addition to cleaning and
disinfecting surfaces between cases,
AORN recommendations indicate
that surgical procedure rooms and
scrub/utility areas should also be
terminally cleaned daily. For terminal
cleaning, Clorox Healthcare offers the
total solution: powerful surface treatment with EPA-registered manual
disinfectants followed by ultraviolet
radiation (UV-C) technology with the
Clorox Healthcare™ Optimum UV™
System to inactivate dangerous and
persistent pathogens, including Clostridium difficile and Methicillin-resis-tant Staphylococcus aureus (MRSA),
adding an extra layer of protection to
make surgical settings safer for patients and staff.
The incidence and burden of SSIs can be staggering, but frontline healthcare
professionals have the potential to make an enormous impact on patient safety
using evidence-based infection prevention strategies.
Clorox Healthcare understands the challenges associated with infection
prevention in surgical settings and is committed to helping healthcare facilities fight back by providing easy-to-use products that are designed to support
current evidence-based SSI prevention strategies by targeting key infection
risk factors – contamination of the patient’s skin and the OR environment.
1Zimlichman E, Henderson D, Tamir O, et al. “Health care–associated infections: a me-ta-analysis of costs and financial impact on the U.S. health care system.” JAMA Intern
Medicine 173.22 (2013):2039–2046.
2Anderson DJ, Podgorny K, Berrios-Torres SI, et al. “Strategies to Prevent Surgical Site
Infections in Acute Care Hospitals: 2014 Update.” Infection Control and Hospital Epidemiology 35. 6 (2014):605-627.
3Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. “Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related
mortality and costs.” Infection Control and Hospital Epidemiology 32. 2 (2011):101–114.
4Mangram AJ, Horan TC, Pearson ML, et al. “The Hospital Infection Control Practices Advisory Committee guideline for prevention of surgical site infection.” American Journal of
Infection Control 27 (1999): 97-134.
For more information about strategies to reduce the risk of SSIs and other
HAIs, including educational resources and product information, visit
The Bundled Approach to Reducing Key Surgical
Site Infection Risk Factors
By: Rosie D. Lyles MD, Head of Clinical Affairs for Clorox Healthcare