Surgical site infections (SSIs) are a major cause of postoperative illness, longer hospitalization, and increased healthcare costs, making the prevention and treatment of SSIs an important aspect of patient care for hospitalists. The following module outlines the different patient and procedural risk factors that influence SSIs, examines the basic principles of antimicrobial prophylaxis for SSI, reviews nonantibiotic interventions to lessen the risk of SSI, and outlines evaluation for and treatment of an SSI. In addition, a discussion of the controversy surrounding preoperative decolonization of Staphylococcus aureus is provided.

To provide hospitalists with best practices to optimally prevent and treat surgical site infections.

This activity is designed for hospitalists. No prerequisites required.

After completing the module, the participant should be able to:

1. Identify patient- and procedure-associated risk factors for the development of surgical site infections (SSIs).
2. Discuss the basic principles of antimicrobial prophylaxis for SSI, including aspects of drug selection, timing of administration, and the need for intraoperative redosing during prolonged surgical cases.
3. Describe nonantibiotic interventions designed to reduce a patient’s risk of developing SSIs, including prevention of hypothermia, reduction of hyperglycemia, and appropriate hair removal practices.
4. Evaluate the controversy surrounding preoperative decolonization of Staphylococcus aureus.
5. Develop an approach to the assessment and treatment of a patient with a possible SSI.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

Accreditation Statement: The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide CME for physicians.

Credit Designation Statement: The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 2 AMA PRA Category 1 Credit(s)^™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release date: December 15, 2008. Expiration date: December 15, 2012.

Estimated time to complete activity: 2 hours

Full Disclosure Policy Affecting CME Activities: As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of The Johns Hopkins University School of Medicine to require the disclosure of the existence of any relevant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following:

^*Assistant Professor of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

^†Assistant Professor of Medicine, Chief Hospital Epidemiologist, Vanderbilt University Medical Center, Nashville, Tennessee.

Conflict of Interest: Dr Rice reports holding stock in Eli Lilly and Company; Dr Talbot report having no relevant financial or advisory relationships with corporate organizations related to this activity.

Off-Label Product Discussion: All faculty have indicated that they have not referenced unlabeled or unapproved uses of drugs or devices.

Disclaimer: The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Address correspondence to: Elizabeth A. Rice, MD, Assistant Professor of Medicine, Vanderbilt University Medical Center, 7th Floor MCE 8550, Nashville, Tennessee. E-mail: elizabeth.rice@vanderbilt.edu.

Click here to download the references for this educational activity.

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 5 sections: an unaccredited pre-test, a study activity, and a CME post-test. All 5 sections must be completed to receive CME credit.

Supported by an educational grant from Merck & Co., Inc.