In addition to the proper use of prophylactic antibiotics and good surgical technique, other factors under the control of the operative team have been demonstrated to affect significantly the risk of SSI. These other factors include basic prevention strategies. All of these preventive measures provide opportunities for improvement in most hospitals.

Changes for Improvement

• Exclude patients with prior infections
• Stop patient tobacco use prior to surgery
• Apply sterile dressing for 24–48 hr
• Shower with antiseptic soap
• Provide positive pressure ventilation in OR with at least 15 air changes/hr
• Keep OR doors closed
• Use sterile instruments
• Wear a mask
• Cover hair
• Prepare skin with appropriate agent
• Wear sterile gloves; double-glove
• Maintain short nails; remove artificial nails
• Handle tissue gently
• Ensure that surgeons/staff clean hands with appropriate agents and methods
• Delay primary closure for heavily contaminated wounds 
• Exclude infected surgeons 
• Use closed suction drains (when used)