refers to an alcohol-based preparation designed for application to the hands to inactivate microorganisms and/or temporarily suppress their growth. Such preparations may contain one or more types of alcohol, other active ingredients with excipients and humectants.

refer to sterile, film-forming cyanoacrylate-based sealants that are commonly used as additional antimicrobial skin preparation after antisepsis and prior to skin incision. These sealants are intended to remain in place and block the migration of flora from surrounding skin into the surgical site by dissolving for several days postoperatively.

is an approach used to assess the quality of a body of evidence and to develop and report recommendations.

also referred to as “nosocomial” or “hospital” infection, is an infection occurring in a patient during the process of care in a hospital or other health care facility, which was not present or incubating at the time of admission. Health care-associated infections can also appear after discharge. They represent the most frequent adverse event during care.

refers to the treatment of hands with an antiseptic handrub to reduce the transient flora without necessarily affecting the resident skin flora. These preparations are broad spectrum and fast-acting, and persistent activity is not necessary.

refers to the treatment of hands with an antiseptic handwash and water to reduce the transient flora without necessarily affecting the resident skin flora. It is broad spectrum, but it is usually less efficacious and acts more slowly than hygienic handrub.

refer to modern (post-1980) dressing materials that are designed to promote the wound healing process through the creation and maintenance of a local, warm, moist environment underneath the chosen dressing when left in place for a period indicated through a continuous assessment process. Examples are alginates, semipermeable film membranes, foams, hydrocolloids and fibrous hydrocolloids, non-adherent wound contact materials and combinations of those.

refer to a preparation containing iodine complexed with a solubilizing agent, such as a surfactant or povidone (forming povidone-iodine). The result is a water-soluble material that releases free iodine when in solution. Iodophors are prepared by mixing iodine with the solubilizing agent; heat can be used to speed up the reaction.

WHO Member States are grouped into four income groups (low, lower-middle, upper-middle, and high) based on the World Bank list of analytical income classification of economies for the 2014 fiscal year, calculated using the World Bank Atlas method. For the current (2016) fiscal year, low-income economies are defined as those with a gross national income (GNI) per capita of US$ 1045 or less in 2014; middle-income economies are those with a GNI per capita of more than US$ 1045, but less than US$ 12 736; (lower-middle-income and upper-middle-income economies are separated at a GNI per capita of US$ 4125) high-income economies are those with a GNI per capita of US$ 12 736 or more.

refers to the preoperative administration of substances to induce voiding of the intestinal and colonic contents.

infants, children, and adolescents, within an age limit usually ranging from birth up to 18 years of age.

refers to the proportion of individuals with a particular disease or attribute measured on a particular date.

Note: Prevalence differs from incidence in that prevalence includes all cases, both new and preexisting, in the population at the specified time, whereas incidence is limited to new cases only.

is defined as closure of the skin level during the original surgery, regardless of the presence of wires, wicks, drains, or other devices or objects extruding through the incision. This category includes surgeries where the skin is closed by some means. Thus, if any portion of the incision is closed at the skin level, by any manner, a designation of primary closure should be assigned to the surgery.

refers to microorganisms residing under the superficial cells of the stratum corneum and found also on the surface of the skin.

refers to the prevention of infectious complications by administering an effective antimicrobial agent prior to exposure to contamination during surgery.

refers to an antiseptic handwash or antiseptic handrub performed preoperatively by the surgical team to eliminate transient flora and reduce resident skin flora. Such antiseptics often have persistent antimicrobial activity.

refers to surgical hand preparation with a waterless alcohol-based handrub.

refers to surgical hand preparation with antimicrobial soap and water.

refers to an operation where at least one incision (including a laparoscopic approach) is made through the skin or mucous membrane, or reoperation via an incision that was left open during a prior operative procedure AND takes place in an operating room.

refers to an infection that occurs after surgery in the part of the body where the surgery took place. Surgical site infections can sometimes be superficial infections involving the skin only. Other surgical site infections are more serious and can involve tissues under the skin, organs, or implanted material.

(Source: United States Centers for Disease Control and Prevention. https://www.cdc.gov/HAI/ssi/ssi.html, accessed 11 July 2016).

is also defined as an infection that occurs within 30 days after the operation and involves the skin and subcutaneous tissue of the incision (superficial incisional) and/or the deep soft tissue (for example, fascia, muscle) of the incision (deep incisional) and/or any part of the anatomy (for example, organs and spaces) other than the incision that was opened or manipulated during an operation (organ/space).

(Source: European Centre for Disease Prevention and Control. http://ecdc.europa.eu/en/publications/Publications/120215_TED_SSI_protocol.pdf, accessed 16 August 2016).

refers to deaths that are directly attributable to SSI. The numerators refer to surgical patients whose cause of death was directly attributable to SSI and the denominator usually refers to all surgical patients in a patient population.

per 100 operative procedures are calculated by dividing the number of surgical site infections by the number of specific operative procedures and multiplying the results by 100. Surgical site infection rate calculations can be performed separately for the different types of operative procedures and stratified by the basic risk index.

are tools or devices that perform such functions as cutting, dissecting, grasping, holding, retracting, or suturing the surgical site. Most surgical instruments are made from stainless steel.

refers to a wound created when an incision is made with a scalpel or other sharp cutting device and then closed in the operating room by suture, staple, adhesive tape, or glue and resulting in close approximation to the skin edges.

refers to microorganisms that colonize the superficial layers of the skin and are more amenable to removal by routine handwashing/handrubbing.

is a term describing a person whose body weight is considered too low to be healthy. The definition usually refers to people with a body mass index of under 18.5 or a weight 15–20% below the norm for their age and height group.

are divided into four classes.

1. Clean refers to an uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital or uninfected urinary tracts are not entered. In addition, clean wounds are primarily closed and, if necessary, drained with closed drainage. Operative incisional wounds that follow non-penetrating (blunt) trauma should be included in this category if they meet the criteria.
2. Clean-contaminated refers to operative wounds in which the respiratory, alimentary, genital or urinary tracts are entered under controlled conditions and without unusual contamination. Specifically, operations involving the biliary tract, appendix, vagina and oropharynx are included in this category, provided no evidence of infection or major break in technique is encountered.
3. Contaminated refers to open, fresh, accidental wounds. In addition, operations with major breaks in sterile technique (for example, open cardiac massage) or gross spillage from the gastrointestinal tract, and incisions in which acute, non-purulent inflammation is encountered, including necrotic tissue without evidence of purulent drainage (for example, dry gangrene), are included in this category.
4. Dirty or infected includes old traumatic wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera. This definition suggests that the organisms causing postoperative infection were present in the operative field before the operation.
   (Source: United States Centers for Disease Control and Prevention. https://www.cdc.gov/hicpac/SSI/table7-8-9-10-SSI.html, accessed 11 July 2016.)