PERIOPERATIVE PRACTICE Table 2
The second paper in the series printed in The Lancet identifies intraoperative and post operative measures, making the following recommendations.8 Recommendation
Strength of the recommendation and Quality of the evidence
Adult patients undergoing general anaesthesia with endotracheal intubation for surgical procedures Strong recommendation should receive 80% fraction of inspired oxygen intraoperatively and, if feasible, in the immediate
(moderate)
postoperative period for 2-6 h. Warming devices are suggested for use in the operating room and
during the surgical procedure for patient body warming.
Goal directed fluid therapy is suggested for use intraoperatively. Either sterile disposable nonwoven or sterile reusable woven
drapes and surgical gowns can be used during surgical operations. Plastic adhesive incise drapes with or without antimicrobial
properties should not be used.
Consider the use of wound protector devices in clean-contaminated, contaminated and dirty abdominal surgical procedures.
Consider the use of irrigation of the incisional wound with an aqueous povidine-iodine solution before closure, particularly in clean and clean-contaminated wounds.
Antibiotic incisional wound irrigation before closure should not be used. Prophylactic negative pressure wound therapy on primarily closed surgical incisions
is suggested in high risk wounds, while taking resources into account. Triclosan – coated sutures are suggested to be used in all types
of surgery.
Laminar airflow ventilation systems should not be used for patients undergoing total arthroplasty surgery.
Perioperative surgical antibiotic prophylaxis should not be continued because of the presence of a wound drain for the purpose of preventing SSIs.
The wound drain should be removed when clinically indicated; no evidence was found to make a recommendation on the optimal exact timing.
No type of advanced dressing should be used over a standard dressing on primarily closed surgical wounds.
Surgical antibiotic prophylaxis administration should not be prolonged after the completion of the operation.
Conditional recommendation (moderate)
Protocols are to be used for perioperative blood glucose control for both diabetic and non diabetic Conditional recommendation adult patients undergoing surgical procedures.
(low)
Conditional recommendation (low) Conditional recommendation
(moderate to very low)
Conditional recommendation (low to very low)
Conditional recommendation (very low)
Conditional recommendation (low)
Conditional recommendation (low) Conditional recommendation
(low)
Conditional recommendation (moderate)
Conditional recommendation (low to very low)
Conditional recommendation (very low)
Conditional recommendation (very low)
Conditional recommendation (low)
Strong recommendation (moderate)
Eliminat the ris
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