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Guideline for Prevention of Surgical Site Infection, 1999

  • Alicia J. Mangram (a1), Teresa C. Horan (a1), Michele L. Pearson (a1), Leah Christine Silver (a1), William R. Jarvis (a1) and The Hospital Infection Control Practices Advisory Committee...

The “Guideline for Prevention of Surgical Site Infection, 1999” presents the Centers for Disease Control and Prevention (CDC)'s recommendations for the prevention of surgical site infections (SSIs), formerly called surgical wound infections. This two-part guideline updates and replaces previous guidelines.

Part I, “Surgical Site Infection: An Overview,” describes the epidemiology, definitions, microbiology, pathogenesis, and surveillance of SSIs. Included is a detailed discussion of the pre-, intra-, and postoperative issues relevant to SSI genesis.

Corresponding author
SSI Guideline, Hospital Infections Program, Mailstop E69, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333
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1.Garner JS. CDC guideline for prevention of surgical wound infections, 1985. Supercedes guideline for prevention of surgical wound infections published in 1982. (Originally published in 1995). Revised. Infect Control 1986;7(3:193200.
2.Simmons BRGuideline for prevention of surgical wound infections. Infect Control 1982;3:185196.
3.Garner JS. The CDC Hospital Infection Control Practices Advisory Committee. Am J Infect Control 1993;21:160–2.
4.Hecht AD. Creating greater efficiency in ambulatory surgery. J Clin Anesth 1995;7:581–4.
5.Horwitz JR, Chwals WJ, Doski JJ, Suescun EACheu HW, Lally KEPediatric wound infections: a prospective multicenter study. Ann Surg 1998;227:553–8.
6.Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a metaanalysis. J Am Coll Surg 1998;186:545–53.
7.Mayol J, Garcia-Aguilar J, Ortiz-Oshiro E, De-Diego Carmona JAFerndandez-Represa JARisks of the minimal access approach for laparoscopic surgery: multivariate analysis of morbidity related to umbilical trocar insertion. World J Surg 1997;21:529–33.
8.Lacy AM, Garcia-Valdecasas JC, Delgado S, Grande LFuster J, Tabet J, et al. Postoperative complications of laparoscopic-assisted colectomy. Surg Endose 1997;11:119–22.
9.Pagni S, Salloum EJ, Tobin GR, VanHimbergen DJ, Spence PASerious wound infections after minimally invasive coronary bypass procedures. Ann Thorac Surg 1998;66:92–4.
10.The Southern Surgeons Club. A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med 1991;324:10738.
11.Centers for Disease Control and Prevention. National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1997, issued May 1997. Am J Infect Control 1997;25:477–87.
12.Food and Drug Administration. Topical antimicrobial drug products for over-the-counter human use: tentative final monograph for health-care antiseptic drug products—proposed rule (21 CFR Parts 333 and 369). Federal Register 1994;59:3144152.
13.Centers for Disease Control and Prevention, National Center for Health Statistics. Vital and Health Statistics, Detailed Diagnoses and Procedures, National Hospital Discharge Survey, 1994. Vol 127. Hyattsville, Maryland: DHHS Publication; 1997.
14.Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993;6(4:428–42.
15.Cruse EWound infection surveillance. Rev Infect Dis 1981;4(3:734–7.
16.Cruse PJ, Foord RThe epidemiology of wound infection: a 10-year prospective study of 62,939 wounds. Surg Clin North Am 1980;60(1): 2740.
17.Martone WJ, Jarvis WR, Culver DH, Haley RW. Incidence and nature of endemic and epidemic nosocomial infections. In: Bennett JV, Brachman PS, eds. Hospital Infections. 3rd ed. Boston: Little, Brown and Co; 1992. p. 577–96.
18.Boyce JM, Potter-Bynoe G, Dziobek L. Hospital reimbursement patterns among patients with surgical wound infections following open heart surgery. Infect Control Hosp Epidemiol 1990;11(2):8993.
19.Poulsen KB, Bremmelgaard ASorensen AI, Raahave D, Petersen JV. Estimated costs of postoperative wound infections. A case-control study of marginal hospital and social security costs. Epidemiol Infect 1994;113(2:283–95.
20.Vegas AAJodra VM, Garcia MLNosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization. Eur J Epidemiol 1993;9(5:504–10.
21.Albers BAPatka P, Haarman HJ, Kostense PJ. Cost effectiveness of preventive antibiotic administration for lowering risk of infection by 0.25%. [German]. Unfallchirurg 1994;97(12:625–8.
22.Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13(10:606–8.
23.Ehrenkranz NJ, Richter EI, Phillips PM, Shultz JM. An apparent excess of operative site infections: analyses to evaluate false-positive diagnoses. Infect Control Hosp Epidemiol 1995;16(12:712–6.
24.Taylor G, McKenzie M, Kirkland T, Wiens REffect of surgeon's diagnosis on surgical wound infection rates. Am J Infect Control 1990;18(5:295–9.
25.SHEA APIC, CDC, SIS. Consensus paper on the surveillance of surgical wound infections. Infect Control Hosp Epidemiol 1992;13(10): 599605.
26.Nooyen SM, Overbeek BP, Brutel de la Riviere A, Storm AJ, Langemeyer JM. Prospective randomised comparison of single-dose versus multiple-dose cefuroxime for prophylaxis in coronary artery bypass grafting. Eur J Clin Microbiol Infect Dis 1994;13:10337.
27.Centers for Disease Control and Prevention. National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1996, issued May 1996. A report from the National Nosocomial Infections Surveillance (NNIS) System. Ann J Infect Control 1996;24:380–8.
28.Schaberg DRResistant gram-positive organisms. Ann Emerg Med 1994;24(3:462–4.
29.Schaberg DR, Culver DH, Gaynes RP. Major trends in the microbial etiology of nosocomial infection. Am J Med 1991;91(3B):72S5S.
30.Jarvis WR. Epidemiology of nosocomial fungal infections, with emphasis on Candida species, din Infect Dis 1995;20:152630.
31.Centers for Disease Control. Nosocomial outbreak of Rhizopus infections associated with Elastoplast wound dressings—Minnesota. MMWR 1978;27:33–4.
32.Pearson RD, Valenti WM, Steigbigel RT. Clostridium perfringens wound infections associated with elastic bandages. JAMA 1980;244:112830.
33.Richet HM, Craven PC, Brown JM, Lasker BACox CD, McNeil MM, et al. A cluster of Rhodococcus (Gordona) bronchialis sternal-wound infections after coronary-artery bypass surgery. N Engl J Med 1991;324:104–9.
34.Wenger PN, Brown JM, McNeil MM, Jarvis WRNocardia farcinica sternotomy site infections in patients following open heart surgery. J Infect Dis 1998;178:153943.
35.Lowry PW, Blankenship RJ, Gridley W, Troup NJ, Tompkins LS. A cluster of Legionella sternal-wound infections due to postoperative topical exposure to contaminated tap water. N Engl J Med 1991;324: 109–13.
36.Bassett DC, Stokes KJ, Thomas WR. Wound infection with Pseudomonas multivorans: a water-borne contaminant of disinfectant solutions. Lancet 1970;1:118891.
37.Cruse PJ. Surgical wound infection. In: Wonsiewicz MJ, ed. Infectious Diseases. Philadelphia: W.B. Saunders Co; 1992. p. 758–64.
38.Altemeier WA, Culbertson WR. Surgical infection. In: Moyer CARhoads JE, Allen JG, Harkins HN, eds. Surgery, principles and practice. 3rd ed. Philadelphia: JB Lippincott; 1965. p. 5177.
39.Krizek TJ, Robson MC. Evolution of quantitative bacteriology in wound management. Am J Surg 1975;130:579–84.
40.Elek SD, Conen PE. The virulence of Staphylococcus pyogenes for man: a study of problems with wound infection. Br J Exp Pathol 1957;38: 573–86.
41.Noble WC. The production of subcutaneous staphylococcal skin lesions in mice. Br J Exp Pathol 1965;46:254–62.
42.James RC, MacLeod CJ. Induction of staphylococcal infections in mice with small inocula introduced on sutures. Br J Exp Pathol 1961;42: 266–77.
43.Henderson B, Poole S, Wilson M. Microbial/host interactions in health and disease: who controls the cytokine network? Immunopharmacology 1996;35:121.
44.Morrison DC, Ryan JL. Endotoxins and disease mechanisms. Ann Rev Med 1987;38:417–32.
45.Demling R, LaLonde C, Saldinger P, Knox J. Multiple-organ dysfunction in the surgical patient: pathophysiology, prevention, and treatment. Curr Probi Surg 1993;30:345414.
46.Eiseman B, Beart R, Norton L. Multiple organ failure. Surg Gynecol Obstet 1977;14:323–6.
47.Fry DE, Pearlstein L, Fulton RL, Polk HC Jr., Multiple system organ failure: the role of uncontrolled infection. Arch Surg 1980;115:136–40.
48.Kasper DL. Bacterial capsule—old dogmas and new tricks. J Infect Dis 1986;153:407–15.
49.Dellinger EP. Surgical infections and choice of antibiotics. In: Sabiston DC, ed. Textbook of Surgery. The Biological Basis of Modern Surgical Practice. 15th ed. Philadelphia: W.B. Saunders Co; 1997. p. 264–80.
50.Goeau-Brissonniere O, Leport C, Guidoin R, Lebrault C, Pechere JC, Bacourt F. Experimental colonization of an expanded polytetrafluo-roethylene vascular graft with Staphylococcus aureus: a quantitative and morphologic study. J Vase Surg 1987;5(5:743–8.
51.Bergamini TM, Corpus RA Jr., Brittian KRPeyton JC, Cheadle WG. The natural history of bacterial biofilm graft infection. J Surg Res 1994;56:393–6.
52.Baddour IM, Christensen GD, Hester MG, Bisno ALProduction of experimental endocarditis by coagulase-negative staphylococci: variability in species virulence. J Infect Dis 1984;150:721–7.
53.Christensen GD, Baddour LM, Simpson WAPhenotypic variation of Staphylococcus epidermidis slime production in vitro and in vivo. Infect Immun 1987;55:28707.
54.Mayberry-Carson KJ, Tober-Meyer B, Smith JK, Lambe DW Jr., Costerton JW. Bacterial adherence and glycocalyx formation in osteomyelitis experimentally induced with Staphylococcus aureus. Infect Immun 1984;43:825–33.
55.Mills J, Pulliam L, Dali L, Marzouk J, Wilson W, Costerton JW. Exopolysaccharide production by viridans streptococci in experimental endocarditis. Infect Immun 1984;43:359–67.
56.Kaebnick HW, Bandyk DF, Bergamini TM, Towne JB. The microbiology of explanted vascular prostheses. Surgery 1987;102:756–61.
57.Atemeier WA, Culbertson WR, Hummel RPSurgical considerations of endogenous infections—sources, types, and methods of control. Surg Clin North Am 1968;48:227–40.
58.Wiley AM, Ha'eri GB. Routes of infection: a study of using “tracer particles” in the orthopedic operating room. Clin Orthop 1979;139:150–5.
59.Slaughter L, Morris JE, Starr AProsthetic valvular endocarditis. A 12-year review. Circulation 1973;47:131926.
60.Carlsson AK, Lidgren L, Lindberg LProphylactic antibiotics against early and late deep infections after total hip replacements. Acta Orthop Scand 1977;48:405–10.
61.Hunter JG, Padilla M, Cooper-Vastola S. Late Clostridium perfringens breast implant infection after dental treatment. Ann Plast Surg 1996;36(3:309–12.
62.Stuesse DC, Robinson JH, Durzinsky DS. A late sternal wound infection caused by hematogenous spread of bacteria. Chest 1995;108(6:17423.
63.Howe CW. Experimental wound sepsis from transient Escherichia coli bacteremia. Surgery 1969;66:570–4.
64.Velasco E, Thuler LC, Martins CA, Dias LM, Conalves VM. Risk factors for infectious complications after abdominal surgery for malignant disease. Am JInfect Control 1996;24(1:16.
65.Bruun JN. Post-operative wound infection. Predisposing factors and the effect of a reduction in the dissemination of staphylococci. Acta Med Scand Suppl 1970;514(Suppl):389.
66.Simchen E, Rozin R, Wax Y. The Israeli Study of Surgical Infection of drains and the risk of wound infection in operations for hernia. Surg Gynecol Obstet 1990;170:331–7.
67.Edwards ID. The epidemiology of 2056 remote site infections and 1966 surgical wound infections occurring in 1865 patients: a four year study of 40,923 operations at Rush-Presbyterian-St. Luke's Hospital, Chicago. Ann Surg 1976;184:758–66.
68.Valentine RJ, Weigelt JADryer D, Rodgers C. Effect of remote infections on clean wound infection rates. Am J Infect Control 1986;14:64–7.
69.Cioffi GATerezhalmy GT, Taybos GM. Total joint replacement: a consideration for antimicrobial prophylaxis. Oral Surg Oral Med Oral Pathol 1988;66(1:124–9.
70.Heggeness MH, Esses SI, Errico T, Yuan HA. Late infection of spinal instrumentation by hematogenous seeding. Spine 1993;18(4:492–6.
71.Mont MAWaldman B, Banerjee C, Pacheco IH, Hungerford DS. Multiple irrigation, debridement, and retention of components in infected total knee arthroplasty. J Arthroplasty 1997;12(4:426–33.
72.Ozuna RM, Delamarter RB. Pyogenic vertebral osteomyelitis and postsurgical disc space infections. Ortho Clin North Am 1996;27(1): 8794.
73.Schmalzried TP, Amstutz HC, Au MK, Dorey FJ. Etiology of deep sepsis in total hip arthroplasty. The significance of hematogenous and recurrent infections. Clin Orthop 1992;280:200–7.
74.Calia FM, Wolinsky E, Mortimer EA Jr., Abrams JS, Rammelkamp CH Jr.Importance of the carrier state as a source of Staphylococcus aureus in wound sepsis. J Hyg (Lond) 1969;67:4957.
75.Dineen P, Drusin LEpidemics of postoperative wound infections associated with hair carriers. Lancet 1973;2(7839:11579.
76.Mastro TD, Farley TA, Elliott JA, Facklam RRPerks JR, Hadler JL, et al. An outbreak of surgical-wound infections due to group A streptococcus carried on the scalp. N Engl J Med 1990;323:968–72.
77.Ford CR, Peterson DE, Mitchell CRAn appraisal of the role of surgical face masks. Am J Surg 1967;113:787–90.
78.Letts RM, Doermer E. Conversation in the operating theater as a cause of airborne bacterial contamination. J Bone Joint Surg [Am] 1983;65:357–62.
79.Giamarellou H, Antoniadou AEpidemiology, diagnosis, and therapy of fungal infections in surgery. Infect Control Hosp Epidemiol 1996;17(8:558–64.
80.Lee JT. Surgical wound infections: surveillance for quality improvement. In: Fry DE, ed. Surgical Infections. Boston: Little, Brown and Co; 1995. p. 145–59.
81.Perl TM, Golub JE. New approaches to reduce Staphylococcus aureus nosocomial infection rates: treating S. aureus nasal carriage. Ann Pharmacother 1998;32:S7S16.
82.Kluytmans JAMouton JW, Ijzerman EP, Vandenbroucke-Grauls CM, Maat AW, Wagenvoort JH, et al. Nasal carriage of Staphylococcus aureus as a major risk factor for wound infections after cardiac surgery. J Infect Dis 1995;171:216–9.
83.Perl TM, Cullen JJ, Pfaller MAWenzel RP, Herwaldt LAThe MARS Study Team. A randomized, double-blind, placebo-controlled clinical trial of intranasal mupirocin ointment (IM) for prevention of S. aureus surgical site infections (SSI) [abstract]. Abstracts of the IDSA 36th Annual Meeting 1998;91(88).
84.Gil-Egea MJ, Pi-Sunyer MT, Verdaguer ASanz F, Sitges-Serra A Eleizegui LT. Surgical wound infections: prospective study of 4,486 clean wounds. Infect Control 1987;8(7:277–80.
85.Nagachinta T, Stephens M, Reitz B, Polk BERisk factors for surgical-wound infection following cardiac surgery. J Infect Dis 1987;156:967–73.
86.Iilienfeld DE, Vlahov D, Tenney JH, McLaughlin JS. Obesity and diabetes as risk factors for postoperative wound infections after cardiac surgery. Am J Infect Control 1988;16:36.
87.Slaughter MS, Olson MM, Lee JT Jr., Ward HB. A fifteen-year wound surveillance study after coronary artery bypass. Ann Thorac Surg 1993;56(5:10638.
88.Bryan AJ, Lamarra M, Angelini GD, West RR, Breckenridge IM. Median sternotomy wound dehiscence: a retrospective case control study of risk factors and outcome. J R Coll Surg Edinb 1992;37:305–8.
89.Jones JK, Triplett RG. The relationship of cigarette smoking to impaired intraoral wound healing: a review of evidence and implications for patient care. J Oral Maxillofac Surg 1992;50(3):237–9; discussion 23940.
90.Vinton AL, Traverso LW, Jolly PC. Wound complications after modified radical mastectomy compared with tylectomy with axillary lymph node dissection. Am J Surg 1991;161(5:584–8.
91.Holley DT, Toursarkissian B, Vansconez HC, Wells MD, Kenady DE, Sloan DAThe ramifications of immediate reconstruction in the management of breast cancer. Am Surg 1995;61(1:60–5.
92.Beitsch P, Balch C. Operative morbidity and risk factor assessment in melanoma patients undergoing inguinal lymph node dissection. Am J Surg 1992;164(5):462–6; discussion 465-6.
93.Post S, Betzier M, von Ditfurth B, Schurmann G, Kuppers P, Herfarth C. Risks of intestinal anastomoses in Crohn's disease. Ann Surg 1991;213(1:3742.
94.B'erard F, Gandon J. Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and of various other factors. Ann Surg 1964;160(Suppl 1):1192.
95.Nystrom PO, Jonstam AHojer H, Ling L. Incisional infection after colorectal surgery in obese patients. Acta Chir Scand 1987;153:225–7.
96.He GW, Ryan WH, Acuff TE, Bowman RT, Douthit MB, Yang CQ, et al. Risk factors for operative mortality and sternal wound infection in bilateral internal mammary artery grafting. J Thorac Cardiovasc Surg 1994;107(1:196202.
97.Barber GR, Miransky J, Brown AE, Coit DG, Lewis FM, Thaler HT, et al. Direct observations of surgical wound infections at a comprehensive cancer center. Arch Surg 1995;130(10:10427.
98.Cruse PJ, Foord RA five-year prospective study of 23,649 surgical wounds. Arch Surg 1973;107:206–10.
99.Claesson BE, Holmlund DE. Predictors of intraoperative bacterial contamination and postoperative infection in elective colorectal surgery. J Hosp Infect 1988;11:127–35.
100.Mishriki SF, Law DJ, Jeffery PJ. Factors affecting the incidence of postoperative wound infection. J Hosp Infect 1990;16:223–30.
101.Doig CM, Wilkinson AW. Wound infection in a children's hospital. Br J Surg 1976;63:647–50.
102.Sharma LK, Sharma PKPostoperative wound infection in a pediatric surgical service. J Pediatr Surg 1986;21:889–91.
103.Casey J, Flinn WR, Yao JS, Fahey V, Pawlowski J, Bergan JJ. Correlation of immune and nutritional status with wound complications in patients undergoing vascular operations. Surgery 1983;93(6:822–7.
104.Greene KA, Wilde AH, Stulberg BN. Preoperative nutritional status of total joint patients. Relationship to postoperative wound complications. J Arthroplasty 1991;6(4:321–5.
105.Weber TR. A prospective analysis of factors influencing outcome after fundoplication. J Perfiaii- Surg 1995;30(7):1061–3; discussion 10634.
106.Vamvakas EC, Carven JH. Transfusion of white-cell-containing allogeneic blood components and postoperative wound infection: effect of confounding factors. Transfus Med 1998;8:2936.
107.Vamvakas EC, Carven JH, Hibberd PL. Blood transfusion and infection after colorectal cancer surgery. Transfusion 1996;36:10008.
108.Jensen LS, Kissmeyer-Nielsen P, Wolff B, Qvist N. Randomised comparison of leucocyte-depleted versus buffy-coat-poor blood transfusion and complications after colorectal surgery. Lancet 1996;348:841–5.
109.Heiss MM, Mempel W, Jauch KW, Delanoff C, Mayer G, Mempel M, et al. Beneficial effect of autologous blood transfusion on infectious complications after colorectal cancer surgery. Lancet 1993;342:132833.
110.Lidgren L. Postoperative orthopaedic infections in patients with diabetes mellitus. Acta Orthop Scand 1973;44:149–51.
111.Gordon SM, Serkey JM, Barr C, Cosgrove D, Potts W. The relationship between glycosylated hemoglobin (HgAlc) levels and postoperative infections in patients undergoing primary coronary artery bypass surgery (CABG) [abstract]. Infect Control Hosp Epidemiol 1997; 18(No. 5,Part2):29(58).
112.Zerr KJ, Furnary AP, Grunkemeier GL, Bookin S, Kanhere V, Starr A. Glucose control lowers the risk of wound infection in diabetics after open heart operations. Ann Thorac Surg 1997;63(2:356–61.
113.Terranova A. The effects of diabetes mellitus on wound healing. Plast Surg Nurs 1991;11(1):20–5.
114.Ziv Y, Church JM, Fazio VW, King TM, Lavery 1C. Effect of systemic steroids on ileal pouchanal anastomosis in patients with ulcerative colitis. Dis Colon Rectum 1996;39(5:504–8.
115.Pons VG, Denlinger SL, Guglielmo BJ, Octavio J, Flaherty J, Derish PA, et al. Ceftizoxime versus vancomycin and gentamicin in neurosurgical prophylaxis: a randomized, prospective, blinded clinical study. Neurosurgery 1993;33(3):416–22; discussion 422-3.
116.Brown IW Jr, Moor GF, Hummel BW, Marshall WG Jr, Collins JP. Toward further reducing wound infections in cardiac operations. Ann Thorac Surg 1996;62 (6): 1783–9.
117.Christou NV, Nohr CW, Meakins JL. Assessing operative site infection in surgical patients. Arch Surg 1987;122:165–9.
118.Hu SS, Fontaine F, Kelly B, Bradford DS. Nutritional depletion in staged spinal reconstructive surgery. The effect of total parenteral nutrition. Spine 1998;23:14015.
119.Schackert HK, Betzler M, Zimmermann GF, Decker R, Geelhaar H, Edler L, et al. The predictive role of delayed cutaneous hypersensitivity testing in postoperative complications. Surg Gynecol Obstet 1986;162:563–8.
120.Katelaris PH, Bennett GB, Smith RC. Prediction of postoperative complications by clinical and nutritional assessment. Aust N Z J Surg 1986;56:743–7.
121.Leite JF, Antunes CF, Monteiro JC, Pereira BT. Value of nutritional parameters in the prediction of postoperative complications in elective gastrointestinal surgery. Br J Surg 1987;74:426–9.
122.Mullen JL, Gertner MH, Buzby GRGoodhart GL, Rosato EF, Implications of malnutrition in the surgical patient. Arch Surg 1979;114:121–5.
123.Buzby GP, Mullen JL, Matthews DC, Hobbs CL, Rosato EFPrognostic nutritional index in gastrointestinal surgery. Am J Surg 1980;139:160–7.
124.Ellis LM, Copeland EM 3rd, Souba WW. Perioperative nutritional support Surg Clin North Am 1991;71:493507.
125.Haley RW, Culver DH, Morgan WM, White JW, Emori TG, Hooton TM. Identifying patients at high risk of surgical wound infection. A simple, multivariate index of patient susceptibility and wound contamination. Am J Epidemiol 1985;121:206–15.
126.Culver DH, Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG, et al. Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med 1991;91(Suppl 3B):152S–7S.
127.Windsor JAHill GLWeight loss with physiologic impairment. A basic indicator of surgical risk. Ann Surg 1988;207:290–6.
128.Campos AC, Meguid MM. A critical appraisal of the usefulness of perioperative nutritional support. Am J Clin Nutr 1992;55:117–30.
129.McPhee IB, Williams RP, Swanson CE. Factors influencing wound healing after surgery for metastatic disease of the spine. Spine 1998;23: 726–33; discussion 732-3.
130.Mullen JL, Buzby GP, Matthews DC, Smale BF, Rosato EFReduction of operative morbidity and mortality by combined preoperative and postoperative nutritional support. Ann Surg 1980;192:604–13.
131.Windsor JAHill GL. Protein depletion and surgical risk. Aust N Z J Surg 1988;58:711–5.
132.Ulicny KS Jr, Hiratzka LF, Williams RB, Grunkemeier GL, Flege JB Jr, Wright CB, et al. Sternotomy infection: poor prediction by acute phase response and delayed hypersensitivity. Ann Thorac Surg 1990;50:949–58.
133.Shukla HS, Rao RR, Banu N, Gupta RM, Yadav RC. Enteral hyperalimentation in malnourished surgical patients. Indian J Med Res 1984;80:339–46.
134.Moore EE, Jones TN. Benefits of immediate jejunostomy feeding after major abdominal trauma—a prospective, randomized study. J Trauma 1986;26:874–81.
135.Daly JM, Lieberman MD, Goldfine J, Shou J, Weintraub F, Rosato EF, et al. Enteral nutrition with supplemental arginine, RNA and omega-3 fatty acids in patients after operation: immunologic, metabolic, and clinical outcome. Surgery 1992;112:5667.
136.Daly JM, Weintraub FN, Shou J, Rosato EF, Lucia M. Enteral nutrition during multimodality therapy in upper gastrointestinal cancer patients. Ann Surg 1995;221:327–38.
137.Moore FA, Feliciano DV, Andrassy RJ, McArdle AH, Booth FV, Morgenstein-Wagner TB, et al. Early enteral feeding, compared with parenteral, reduces postoperative Tieptic complications. The results of a meta-analysis. Ann Surg 1992;216:172–83.
138.Starker PM, Lasala PAAskanazi J, Gump FE, Forse RA, Kinney JM. The response to TPN: a form of nutritional assessment. Ann Surg 1983;198:7204.
139.Muller JM, Brenner U, Dienst C, Pichlmaier H. Preoperative parenteral feeding in patients with gastrointestinal carcinoma. Lancet 1982;1: 6871.
140.Holter AR, Fischer JE. The effects of perioperative hyperalimentation on complications in patients with carcinoma and weight loss. J Surg Res 1977;23:31–4.
141.Thompson BRJulian TB, Stremple JF. Perioperative total parenteral nutrition in patients with gastrointestinal cancer. J Surg Res 1981;30: 497500.
142.Brennan MF, Pisters PW, Posner M, Quesada O, Shike M. A prospective randomized trial of total parenteral nutrition after major pancreatic resection for malignancy. Ann Surg 1994;220:436–41; discussion 441-4.
143.The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. Perioperative total parenteral nutrition in surgical patients. N Engl J Med 1991;325:525–32.
144.Starker PM; LaSala PA, Askanazi J, Todd G, Hensle TW, Kinney JM. The influence of preoperative total parenteral nutrition upon morbidity and mortality. Surg Gynecol Obstet 1986;162:569–74.
145.Senkal M, Mumme AEickhoff U, Geier C, Spath G, Wulfert D, et al. Early postoperative enteral immunonutrition: clinical outcome and cost-comparison analysis in surgical patients. Crit Care Med 1997;25:148996.
146.Heatley RV, Williams RH, Lewis MH. Pre-operative intravenous feeding—a controlled trial. Postgrad Med J 1979;55:541–5.
147.Muller JM, Keller HW, Brenner U, Walter M, Holzmuller W. Indications and effects of preoperative parenteral nutrition. World J Surg 1986;10: 5363.
148.Daly JM, Massar E, Ciacco G, Frazier OH, Mountain CF, Dudrick SJ, et al. Parenteral nutrition in esophageal cancer patients. Ann Surg 1982;196:203–8.
149.Klein JD, Hey LA, Yu CS, Klein BB, Coufal FJ, Ycmng EP, et al. Perioperative nutrition and postoperative complications in patients undergoing spinal surgery. Spine 1996;21:267682.
150.Garibaldi RA, Cushing D, Lerer T. Risk factors for postoperative infection. Am J Med 1991;91(Suppl 3B):158S63S.
151.Lee JT. Operative complications and quality improvement. Am J Surg 1996;171:545–7.
152.Kluytmans JAMouton JW, Vanden Bergh MF, Manders MJ, Maat AP, et al. Reduction of surgical-site infections in cardiothoracic surgery by elimination of nasal carriage of Staphylococcus aureus. Infect Control Hosp Epidemiol 1996;17:780–5.
153.Boyce JM. Preventing staphylococcal infections by eradicating nasal carriage of Staphylococcus aureus: proceeding with caution. Infect Control Hosp Epidemiol 1996;17:775–9.
154.Blajchman MAAllogeneic blood transfusions, immunomodulation, and postoperative bacterial infection: do we have the answers yet? Transfusion 1997;37:121–5.
155.Garibaldi RAPrevention of intraoperative wound contamination with Chlorhexidine shower and scrub. J Hosp Infect 1988;11(Suppl B):59.
156.Paulson DS. Efficacy evaluation of a 4% Chlorhexidine gluconate as a full-body shower wash. Am J Infect Control 1993;21(4:205–9.
157.Hayek LJ, Emerson JM, Gardner AM. A placebo-controlled trial of the effect of two preoperative baths or showers with Chlorhexidine detergent on postoperative wound infection rates. J Hosp Infect 1987;10: 165–72.
158.Kaiser AB, Kernodle DS, Barg NL, Petracek MRInfluence of preoperative showers on staphylococcal skin colonization: a comparative trial of antiseptic skin cleansers. Ann Thorac Surg 1988;45:35–8.
159.Rotter ML, Larsen SO, Cooke EM, Dankert J, Daschner F, Greco D, et al. A comparison of the effects of preoperative whole-body bathing with detergent alone and with detergent containing Chlorhexidine gluconate on the frequency of wound infections after clean surgery. The European Working Party on Control of Hospital Infections. J Hosp Infect 1988;11:310–20.
160.Leigh DAStrange JL, Marriner J, Sedgwick J. Total body bathing with ‘Hibiscrub’ (Chlorhexidine) in surgical patients: a controlled trizi J Hosp Infect 1983;4:229–35.
161.Ayliffe GA, Noy MF, Babb JR, Davies JG, Jackson J. A comparison of pre-operative bathing with chlorhexidine-detergent and non-medicated soap in the prevention of wound infection. J Hosp Infect 1983;4:237–44.
162.Lynch W, Davey PG, Malek M, Byrne DJ, Napier ACost-effectiveness analysis of the use of Chlorhexidine detergent in preoperative whole-body disinfection in wound infection prophylaxis. J Hosp Infect 1992;21:179–91.
163.Brady LM, Thomson M, Palmer MA, Harkness JLSuccessful control of endemic MRSA in a cardiothoracic surgical unit. Med J Aust 1990;152:240–5.
164.Tuffiteli DJ, Croton RS, Hemingway DM, Hartley MN, Wake PN, Garvey RJ. Methicillin-resistant Staphylococcus aureus; the role of antisepsis in the control of an outbreak. J Hosp Infect 1987;10:255–9.
165.Bartzokas CA, Paton JH, Gibson MF, Graham F, McLoughlin GACroton RS. Control and eradication of methicillin-resistant Staphylococcus aureus on a surgical unit. N Engl J Med 1984;311:14225.
166.Seropian R, Reynolds BM. Wound infections after preoperative depilatory versus razor preparation. Am J Surg 1971;121:251–4.
167.Hamilton HW, Hamilton KR, Lone FJ. Preoperative hair removal. Can J Surg 1977;20:269–71, 274-5.
168.Olson MM, MacCallum J, McQuarrie DG. Preoperative hair removal with clippers does not increase infection rate in clean surgical wounds. Surg Gynecol Obstet 1986;162:181–2.
169.Mehta G, Prakash B, Karmoker S. Computer assisted analysis of wound infection in neurosurgery. J Hosp Infect 1988;11:244–52.
170.Alexander JW, Fischer JE, Boyajian M, Palmquist J, Morris MJ. The influence of hair-removal methods on wound infections. Arch Surg 1983;118(3:347–52.
171.Masterson TM, Rodeheaver GT, Morgan RF, Edlich REBacteriologie evaluation of electric clippers for surgical hair removal. Am J Surg 1984;148:301–2.
172.Sellick JA Jr., Stelmach M, Mylotte JM. Surveillance of surgical wound infections following open heart surgery. Infect Control Hosp Epidemiol 1991;12(10:591–6.
173.Ko W, Lazenby WD, Zelano JA, Zsom W, Krieger KH. Effects of shaving methods and intraoperative irrigation on suppurative mediastinitis after bypass operations. Ann Thorac Surg 1992;53:301–5.
174.Moro ML, Carrieri MP, Tozzi AE, Lana S, Greco D. Risk factors for surgical wound infections in clean surgery: a multicenter study. Italian PRINOS Study Group. Ann Ital Chir 1996;67:13–9.
175.Winston KRHair and neurosurgery. Neurosurgery 1992;31(2:320–9.
176.Larson E. Guideline for use of topical antimicrobial agents. Am J Infect Control 1988;16:253–66.
177.Hardin WD, Nichols RL. Handwashing and patient skin preparation. In: Malangoni MA, ed. Critical Issues in Operating Room Management. Philadelphia: Iippincott-Raven; 1997. p. 133–49.
178.Ritter MA, French MLEitzen HE, Gioe TJ. The antimicrobial effectiveness of operative-site preparative agents: a microbiological and clinical study. J Bone Joint Surg Am 1980;62(5:826–8.
179.Mayhall CG. Surgical infections including burns. In: Wenzel RP, ed. Prevention and Control of Nosocomial Infections. 2nd ed. Baltimore: Williams & Wilkins; 1993. p. 614–64.
180.Committee on Control of Surgical Infections of the Committee on Pre-and Postoperative Care, American College of Surgeons. Manual on Control of Infection in Surgical Patients. Philadelphia: J.B. Lippincott Co; 1984.
181.Hardin WD, Nichols RL. Aseptic technique in the operating room. In: Fry DE, ed. Surgical Infections. Boston: Little, Brown and Co; 1995. p. 109–18.
182.Lowbury EJ, Lilly HAUse of 4 percent Chlorhexidine detergent solution (Hibiscrub) and other methods of skin disinfection. Br Med J 1973;1:510–5.
183.Ay R, Marbach HI. Comparative antibacterial efficacy of a 2-minute surgical scrub with Chlorhexidine gluconate, povidone-iodine, and chlorox-ylenol sponge-brushes. Am J Infect Control 1988;16:173–7.
184.Peterson AF, Rosenberg A, Alatary SD. Comparative evaluation of surgical scrub preparations. Surg Gynecol Obstet 1978;146:63–5.
185.Brown TR, Ehrlich CE, Stehman FB, Golichowski AM, Madura JAEitzen HE. A clinical evaluation of Chlorhexidine gluconate spray as compared with iodophor scrub for preoperative skin preparation. Surg Gynecol Obstet 1984;158:363–6.
186.Lowbury EJ, Lilly HA. The effect of blood on disinfection of surgeons' hands. Br J Surg 1974;61:1921.
187.Association of Operating Room Nurses. Recommended practices for skin preparation of patients. AORNJ 1996;64(5:813–6.
188.Kutarski PW, Grundy HC. To dry or not to dry? An assessment of the possible degradation in efficiency of preoperative skin preparation caused by wiping skin dry. Ann R Coll Surg Engl 1993;75(3:181–5.
189.Gauthier DK, O'Fallon PT, Coppage D. Clean vs sterile surgical skin preparation kits. Cost, safety, effectiveness. AORN J 1993;58(3:486–95.
190.Hagen KS, Treston-Aurand J. A comparison of two skin preps used in cardiac surgical procedures. AORN J 1995;62(3:393402.
191.Shirahatti RG, Joshi RM, Vishwanath YK, Shinkre N, Rao S, Sankpal JS, et al. Effect of pre-operative skin preparation on post-operative wound infection. J Postgrad Med 1993;39(3): 134–6.
192.Larson EL, Butz AM, Gullette DL, Laughon BAAlcohol for surgical scrubbing? Infect Control Hosp Epidemiol 1990;11(3):139–43.
193.Faoagali J, Fong J, George N, Mahoney P, O'Rouke V. Comparison of the immediate, residual, and cumulative antibacterial effects of Novaderm R*, Novascrub R*, Betadine Surgical Scrub, Hibiclens, and liquid soap. Am J Infect Control 1995;23(6):337–43.
194.Larson ELAPIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251–69.
195.Rubio PASeptisol antiseptic foam: a sensible alternative to the conventional surgical scrub. Int Surg 1987;72(4:243–6.
196.Lowbury EJ, Lilly HAAyliffe GAPreoperative disinfection of surgeons' bands: use of alcoholic solutions and effects of gloves on skin flora. Br Med J 1974;4:369–72.
197.Rotter ML. Hygienic hand disinfection. Infect Control 1984;5:1822.
198.Ayliffe GASurgical scrub and skin disinfection. Infect Control 1984;5:23–7.
199.Lilly HALowbury EJ, Wilkins MD, Zaggy ADelayed antimicrobial effects of skin disinfection by alcohol. J Hyg (Land) 1979;82:497500.
200.Nichols RL, Smith JW, Garcia RY, Waterman RS, Holmes JW- Current practices of preoperative bowel preparation among North American colorectal surgeons. Clin Infect Dis 1997;24:609–19.
201.Wade JJ, Casewell MW. The evaluation of residual antimicrobial activity on hands and its clinical relevance. J Hosp Infect 1991;18(Suppl B):23–8.
202.Babb JR, Davies JG, Ayliffe GAA test procedure for evaluating surgical hand disinfection. J Hosp Infect 1991;18(Suppl B):41–9.
203.Holloway PM, Piatt JH, Reybrouck G, Lilly HAMehtar S, Drabu Y. A multi-centre evaluation of two chlorhexidine-containing formulations for surgical hand disinfection. J Hosp Infect 1990;16:151–9.
204.Kobayashi H. Evaluation of surgical scrubbing. J Hosp Infect 1991;18(Suppl B):2934.
205.Nicoletti G, Boghossian V, Borland RHygienic hand disinfection: a comparative study with Chlorhexidine detergents and soap. J Hosp Infect 1990;15:323–37.
206.Rotter ML, Koller W. Surgical hand disinfection: effect of sequential use of two Chlorhexidine preparations. J Hosp Infect 1990;16:161–6.
207.O'shaughnessy M, O'Malley VP, Corbett G, Given HEOptimum duration of surgical scrub-time. Br J Surg 1991;78(6:685–6.
208.Hingst V, Juditzki I, Heeg P, Sonntag HG. Evaluation of the efficacy of surgical hand disinfection following a reduced application time of 3 instead of 5 min. J Hosp Infect 1992;20(2:7986.
209.Wheelock SM, Lookinland S. Effect of surgical hand scrub time on subsequent bacterial growth. AORN J 1997;65:1087–92,1094-8.
210.Deshmukh N, Kramer JW, Kjellberg SI. A comparison of 5-minute povidone-iodine scrub and 1-minute povidone-iodine scrub followed by alcohol foam. Mil Med 1998;163:145–7.
211.Masterson BJ. Cleansing the surgeon's hands. Scientific American Surgeon 1996;2:39.
212.Association of Operating Room Nurses. Standards, Recommended Practices, Guidelines. Denver: Association of Operating Room Nurses; 1999.
213.Pottinger J, Burns S, Manske C. Bacterial carriage by artificial versus natural nails. Am J Infect Control 1989;17:3404.
214.Passaro DJ, Waring L, Armstrong R, Bolding F, Bouvier C, Rosenberg J, et al. Postoperative Serratia marcescens wound infections traced to an out-of-hospital source. J Infect Dis 1997;175(4:992–5.
215.Baumgartner CAMaragos CS, Walz J, Larson E. Effects of nail polish on microbial growth of fingernails. Dispelling sacred cows. AORN J 1993;58:84–8.
216.Jacobson G, Thiele JE, McCune JH, Farrell LD. Handwashing: ring-wearing and number of microorganisms. Nurs Res 1985;34:186–8.
217.Hoffman PN, Cooke EM, McCarville MR, Emmerson AM. Microorganisms isolated from skin under wedding rings worn by hospital staff. Br Med J (Clin Res Ed) 1985;290:206–7.
218.Richet HM, Chidiac C, Prat APol ADavid M, Maccario M, et al. Analysis of risk factors for surgical wound infections following vascular surgery. Am J Med 1991;91(Suppl 3B):170S172S.
219.Centers for Disease Control. Epidemic keratoconjunctivitis in an ophthalmology clinic—California. MMWR 1990;39:598601.
220.Ford E, Nelson KE, Warren D. Epidemiology of epidemic keratoconjunctivitis. Epidemiol Rev 1987;9:244–61.
221.Birenbaum E, Linder N, Varsano N, Azar RKuint J, Spierer A et al. Adenovirus type 8 conjunctivitis outbreak in a neonatal intensive care unit. Arch Dis Child 1993;68(5 Spec No):610–1.
222.Warren D, Nelson KE, Farrar JA, Hurwitz E, Hierholzer J, Ford E, et al. A large outbreak of epidemie keratoconjunctivitis: problems in controlling nosocomial spread. J Infect Dis 1989;160:938–43.
223.Jernigan JALowry BS, Hayden FG, Kyger SAConway BP, Groschel DH, et al. Adenovirus type 8 epidemic keratoconjunctivitis in an eye clinic: risk factors and control. J Infect Dis 1993;167:130713.
224.Boyce JM. Should we vigorously try to contain and control methicillin-resistant Staphylococcus aureus? Infect Control Hosp Epidemiol 1991;12:4654.
225.Boyce JM, Opal SM, Potter-Bynoe G, Medeiros AASpread of methicillin-resistant Staphylococcus aureus in a hospital after exposure to a health care worker with chronic sinusitis. Clin Infect Dis 1993;17: 496504.
226.Sheretz RJ, Reagan DRHampton KD, Robertson KL, Streed SAHoen HM, et al. A cloud adult: the Staphylococcus awreiis-virus interaction revisited. Ann Intern Med 1996;124:539–47.
227.Belani A, Sherertz RJ, Sullivan ML, Russell BA, Reumen PD. Outbreak of staphylococcal infection in two hospital nurseries traced to a single nasal carrier. Infect Control 1986;7:487–90.
228.Kreiswirth BN, Kravitz GR, Schlievert PM, Novick RP. Nosocomial transmission of a strain of Staphylococcus aureus causing toxic shock syndrome. Ann Intern Med 1986;105:704–7.
229.Weber DJ, Rutala WA, Denny FW Jr.Management of healthcare workers with pharyngitis or suspected streptococcal infections. Infect Control Hosp Epidemiol 1996;17:753–61.
230.Viglionese A, Nottebart VF, Bodman HA, Platt RRecurrent group A streptococcal carriage in a health care worker associated with widely separated nosocomial outbreaks. Am J Med 1991;91(3B):329S33S.
231.Paul SM, Genese C, Spitalny KPostoperative group A beta-hemolytic streptococcus outbreak with the pathogen traced to a member of a healthcare worker's household. Infect Control Hosp Epidemiol 1990;11:643–6.
232.Ridgway EJ, Alen KD. Clustering of group A streptococcal infections on a burns unit: important lessons in outbreak management. J Hosp Infect 1993;25:173–82.
233.Berkelman RL, Martin D, Graham DR, Mowry J, Freisem R, Weber JA, et al. Streptococcal wound infection caused by a vaginal carrier. JAMA 1982;247:26802.
234.Schaffner W, Lefkowitz LB Jr., Goodman JS, Koenig MG. Hospital outbreak of infections with group A streptococci traced to an asymptomatic anal carrier. N Engl J Med 1969;280:12245.
235.Richman DD, Breton SJ, Goldman DAScarlet fever and group A streptococcal surgical wound infection traced to an anal carrier. J Pediatr 1977;90:387–90.
236.Stromberg ASchwan A, Cars O. Throat carrier rates of beta-hemolytic streptococci among healthy adults and children. Scand J Infect Dis 1988;20:411–7.
237.Stamm WE, Feeley JC, Facklam RRWound infection due to group A streptococcus traced to a vaginal carrier. J Infect Dis 1978;138:287–92.
238.Bolyard EA, Tablan OC, Williams WW, Pearson ML, Shapiro CN, Deitchman SD, et al. Guideline for infection control in healthcare personnel, 1998. Hospital Infection Control Practices Advisory Committee. Am J Infect Control 1998;26:289354.
239.Nichols RL, Holmes JW. Prophylaxis in bowel surgery. Curr Clin Top Infect Dis 1995;15:7696.
240.Nichols RL, Smith JW, Muzik AC, Love EJ, McSwain NE, Timberlake G, et al. Preventive antibiotic usage in traumatic thoracic injuries requiring closed tube thoracostomy. Chest 1994;106(5:14938.
241.Bullock R, van Dellen JRKetelbey W, Reinach SG. A double-blind placebo-controlled trial of perioperative prophylactic antibiotics for elective neurosurgery. J Neurosurg 1988;69(5:687–91.
242.Page CRBohnen JM, Fletcher JR, McManus AT, Solomkin JS, Wittmann DH. Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care. Arch Surg 1993;128(1:7988.
243.McQueen M, Littlejohn AHughes SP. A comparison of systemic cefuroxime and cefuroxime loaded bone cement in the prevention of early infection after total joint replacement. Int Orthop 1987;11:241–3.
244.Henley MB, Jones RE, Wyatt RWB, Hofmann A, Cohen RL. Prophylaxis with cefamandole nafate in elective orthopedic surgery. Clin Orthop 1986;209:249–54.
245.Buckley R, Hughes GN, Snodgrass T, Huchcroft SAPerioperative cefa-zolin prophylaxis in hip fracture surgery. Can J Surg 1990;33:122–7.
246.Boyd RJ, Burke JF, Colton T. A double-blind clinical trial of prophylactic antibiotic in hip fractures. J Bone Joint Surg [Am] 1973;55A12518.
247.Bernard A, Piliet M, Goudet P, Viard H. Antibiotic prophylaxis in pulmonary surgery. A prospective randomized double-blind trial of flash cefuroxime versus forty-eight-hour cefuroxime. J Thorac Cardiovasc Surg 1994;107(3:896900.
248.Piatt RZucker JR, Zaleznik DF, Hopkins CC, Dellinger EP, Karchmer AW, et al. Perioperative antibiotic prophylaxis and wound infection following breast surgery. J Antimicrob Chemother 1993;31(Suppl B):43–8.
249.Rimoldi RL, Haye W. The use of antibiotics for wound prophylaxis in spinal surgery. Orthop Clin North Am 1996;27(1:4752.
250.Bennion RS, Hiatt JR, Williams RAWilson SE. A randomized, prospective study of perioperative antimicrobial prophylaxis for vascular access surgery. J Cardiovasc Surg (Torino) 1985;26:270–4.
251.Kaiser AB, Petracek MRLea JW 4th, Kernodle DS, Roach AC, Alford WC Jr, et al. Efficacy of cefazolin, cefamandole, and gentamicin as prophylactic agents in cardiac surgery. Results of a prospective, randomized, double-blind trial in 1030 patients. Ann Surg 1987;206(6:791–7.
252.Miedzinski LJ, Callaghan JC, Fanning EA, Gelfand ET, Goldsand G, Modry D, et al. Antimicrobial prophylaxis for open heart operations. Ann Thorac Surg 1990;50:800–7.
253.Doebbeling BN, Pfaller MA Kuhns KR Massanari RM, Behrendt DM, Wenzel RR Cardiovascular surgery prophylaxis. A randomized, controlled comparison of cefazolin and cefuroxime. J Thorac Cardiovasc Surg 1990;99:981–9.
254.Madsen MS, Neumann L, Andersen JAPenicillin prophylaxis in complicated wounds of hands and feet: a randomized, double-blind trial. Injury 1996;27(4:275–8.
255.Burnett JW, Gustilo RB, Williams DN, Kind AC. Prophylactic antibiotics in hip fractures. A double-blind, prospective study. J Bone Joint Surg [Am] 1980;62(3:457–62.
256.Nichols RL, Webb WR, Jones JW, Smith JW, LoCicero J 3rd. Efficacy of antibiotic prophylaxis in high risk gastroduodenal operations. Am J Surg 1982;143:94–8.
257.Lewis RT, Goodall RG, Marien C, Park M, Lloyd-Smith W, Wiegand FM. Efficacy and distribution of single-dose preoperative antibiotic prophylaxis in high-risk gastroduodenal surgery. Am J Surg 1991;34:117–22.
258.Young RF, Lawner PM. Perioperative antibiotic prophylaxis for prevention of postoperative neurosurgical infections. A randomized clinical trial. J Neurosurg 1987;66:701–5.
259.Djindjian M, Lepresle E, Horns JB. Antibiotic prophylaxis during prolonged clean neurosurgery. Results of a randomized double-blind study using oxacillin. J Neurosurg 1990;73:383–6.
260.Targarona EM, Garau J, Munoz-Ramos C, Roset F, Lite J, Matas E, et al. Single-dose antibiotic prophylaxis in patients at high risk for infection in biliary surgery: a prospective and randomized study comparing cefonicid with mezlocillin. Surgery 1990;107:327–34.
261.van Ek B, Dijkmans BA, van Dulken H, van Furth R. Antibiotic prophylaxis in craniotomy: a prospective double-blind placebo-controlled study. Scand J Infect Dis 1988;20:633–9.
262.Krige JE, Isaacs S, Stapleton GN, McNally J. Prospective, randomized study comparing amoxycillin-clavulanic acid and cefamandole for the prevention of wound infection in high-risk patients undergoing elective biliary surgery. J Infect 1992;22 (Suppl A):3341.
263.Browder W, Smith JW, Vivoda LM, Nicholas RL. Nonperforative appendicitis: a continuing surgical dilemma. J Infect Dis 1989;159(6:108894.
264.Piatt R. Guidelines for perioperative antibiotic prophylaxis. In: Abrutyn E, Goldmann DAScheckler WE, eds. Saunders Infection Control Reference Service. Philadelphia: W.B. Saunders Co; 1997. p. 229–34.
265.Sanderson PJ. Antimicrobial prophylaxis in surgery: microbiological factors. J Antimicrob Chemother 1993;31(Suppl B):19.
266.Anonymous. Antimicrobial prophylaxis in surgery. Med Lett Drugs Ther 1997;39(1012:97102.
267.Scher KS. Studies on the duration of antibiotic administration for surgical prophylaxis. Am Surg 1997;63:5962.
268.Nichols RL. Antibiotic prophylaxis in surgery. J Chemother 1989;1(3):170–8.
269.Ehrenkranz NJ. Antimicrobial prophylaxis in surgery: mechanisms, misconceptions, and mischief. Infect Control Hosp Epidemiol 1993;14(2:99106.
270.Berkeley AS, Freedman KS, Ledger WJ, Orr JW, Benigno BB, Gordon SF, et al. Comparison of cefotetan and cefoxitin prophylaxis for abdominal and vaginal hysterectomy. Am J Obstet Gynecol 1988; 158: 706–9.
271.Ehrenkranz NJ, Blackwelder WC, Pfaff SJ, Poppe D, Yerg DE, Kaslow RA. Infections complicating low-risk cesarean sections in community hospitals: efficacy of antimicrobial prophylaxis. Am J Obstet Gynecol 1990;162(2:337–43.
272.Soper DE. Infections following cesarean section. Curr Opin Obstet Gynecol 1993;5(4:517–20.
273.Enkin M, Enkin E, Chalmers I, Hemminki E. Prophylactic antibiotics in association with caesarean section. In: Chalmers I, Enkin M, Keirse MJ, eds. Effective Care in Pregnancy and Childbirth London: Oxford University; 1989. p. 1246–69.
274.Alen JL, Rampon JF, Wheeless CR. Use of a prophylactic antibiotic in elective major gynecologic operations. Obstet Gynecol 1972;39:218–24.
275.The Multicenter Study Group. Single dose prophylaxis in patients undergoing vaginal hysterectomy: cefamandole versus cefotaxime. Am J Obstet Gynecol 1989;160:1198–201.
276.Roy S, Wilkins J, Galaif E, Azen C. Comparative efficacy and safety of cefmetazole or cefoxitin in the prevention of postoperative infection following vaginal and abdominal hysterectomy. J Antimicrob Chemother 1989;23(Suppl D):109–17.
277.Friese S, Willems FT, Loriaux SM, Meewis JM. Prophylaxis in gynaecological surgery: a prospective randomized comparison between single dose prophylaxis with amoxycillin/clavulanate and the combination of cefuroxime and metronidazole. J Antimicrob Chemother 1989;24(Suppl B):213–6.
278.Senior CC, Steigrad SJ. Are preoperative antibiotics helpful in abdominal hysterectomy? Am J Obstet Gynecol 1986;154:10048.
279.Hemsell DL, Martin JN Jr, Pasterek JG 2d, Nobles BJ, Hemsell PG, Helman N, et al. Single dose antimicrobial prophylaxis at abdominal hysterectomy. Cefamandole vs. cefotaxime. J Reprod Med 1988;33: 939–44.
280.Hemsell DL, Hemsell PG, Heard ML, Nobles BJ. Preoperative cefoxitin prophylaxis for elective abdominal hysterectomy. Am J Obstet Gynecol 1985;153:225–6.
281.DiPiro JT, Cheung RP, Bowden TA Jr, Mansberger JA. Single dose systemic antibiotic prophylaxis of surgical wound infections. Am J Surg 1986;152:552–9.
282.Trilla A, Mensa J. Perioperative antibiotic prophylaxis. In: Wenzel RP, ed. Prevention and Control of Nosocomial Infections. 2nd ed. Baltimore: Williams & Wilkins; 1993. p. 665–82.
283.Ehrenkranz NJ, Meakins JL. Surgical infections. In: Bennett JV, Brachman PS, eds. Hospital Infections. 3rd ed. Boston: Little, Brown and Co; 1992. p. 685710.
284.Nichols RL. Surgical antibiotic prophylaxis. Med Clin North Am 1995;79(3:509–22.
285.Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 1992;326(5:281–6.
286.McDonald M, Grabsch E, Marshall C, Forbes A. Single- versus multiple-dose antimicrobial prophylaxis for major surgery: a systematic review. Aust NZJ Surg 1998;68:388–96.
287.Clarke JS, Condon RE, Bartlett JG, Gorbach SL, Nichols RL, Ochi S. Preoperative oral antibiotics reduce septic complications of colon operations: results of prospective, randomized, double-blind clinical study. Ann Surg 1977;186:251–9.
288.Condon RE, Bartlett JG, Greenlee H, Schulte WJ, Ochi S, Abbe Ret al. Efficacy of oral and systemic antibiotic prophylaxis in colorectal operations. Arch Surg 1983;118:496502.
289.Bartlett JG, Condon RE, Gorbach SL, Clarke JS, Nichols RL, Ochi S. Veterans Administration Cooperative Study on bowel preparation for elective colorectal operation: impact of oral antibiotic regimen on colonic flora, wound irrigation cultures and bacteriology of septic complications. Ann Surg 1978;188:249–54.
290.Da Costa A, Kirkorian G, Cucherat M, Delahaye F, Chevalier P, Cerisier A, et al. Antibiotic prophylaxis for permanent pacemaker implantation: a meta-analysis. Circulation 1998;97:1796–801.
291.Bumpous JM, Johnson JT. The infected wound and its management. Otolaryngol Clin North Am 1995;28(5:9871001.
292.Hospital Infection Control Practices Advisory Committee. Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol 1995;16(2:105–13.
293.Forse RA, Karam C, MacLean LD, Christou NV. Antibiotic prophylaxis for surgery in morbidly obese patients. Surgery 1989;106:750–7.
294.Polk HC, Wilson MA. Systemic antibiotic prophylaxis in surgery. In: Fry DE, ed. Surgical Infections. Boston: little, Brown and Co; 1995. p. 127–33.
295.Ayliffe GA. Role of the environment of the operating suite in surgical wound infection. Rev Infect Dis 1991;13(Suppl 10):S8004.
296.Gryska PF, O'Dea AE. Postoperative streptococcal wound infection. The anatomy of an epidemic. JAMA 1970;213:118991.
297.Mclntyre DM. An epidemic of Streptococcus pyogenes puerperal and postoperative sepsis with an unusual carrier site—the anus. Am J Obstet Gynecol 1968;101:308–14.
298.Lidwell OM. Clean air at operation and subsequent sepsis in the joint. Clin Orthop 1986;211:91102.
299.American Institute of Architects. Guidelines for design and construction of hospital and health care facilities. Washington (DC): American Institiute of Architects Press; 1996.
300.Nichols RL. The operating room. In: Bennett JV, Brachman PS, eds. Hospital Infections. 3rd ed. Boston: Little, Brown and Co; 1992. p. 461–73.
301.Laufman H. The operating room. In: Bennett JV, Brachman PS, eds. Hospital Infections. 2nd ed. Boston: Little, Brown and Co; 1986. p. 315–23.
302.Sessler DI, McGuire J, Hynson J, Moayeri A, Heier T. Thermoregulatory vasoconstriction during isoflurane anesthesia minimally decreases cutaneous heat loss. Anesthesiology 1992;76:670–5.
303.Hambraeus AAerobiology in the operating room—a review. J Hosp Infect 1988;11(Suppl A):6876.
304.Babb JR, Lynam P, Ayliffe GARisk of airborne transmission in an operating theatre containing four ultraclean air units. J Hosp Infect 1995;31(3:159–68.
305.Charnley J. Post-operative infection after total hip replacement with special reference to contamination in the operating room. Internal Publication 38, Centre for Hip Surgery, Wrightington Hospital, Wigan, Lanes., UK; 1972.
306.Friberg B. Ultraclean laminar airflow ORs. AORN J 1998;67:841–51.
307.Iidwell OM, Elson RALowbury EJ, Whyte W, Blowers R, Stanley SJ, et al. Ultraclean air and antibiotics for prevention of postoperative infection. A multicenter study of 8,052 joint replacement operations. Acta Orthop Scand 1987;58:413.
308.Nelson JP. The operating room environment and its influence on deep wound infection. J Bone Joint Surg 1976;111.
309.Whyte W. Infection control in hospital operating rooms. Cleanrooms 1993 Proceedings 1993:A5766.
310.Charnley J. A clean-air operating enclosure. Br J Surg 1964;51:202–5.
311.Iidwell OM, Lowbury EJ, Whyte W, Blowers RStanley SJ, Lowe D. Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study. Br Med J 1982;285:10–4.
312.Taylor GJ, Bannister GC, Leeming JPWound disinfection with ultraviolet radiation. J Hosp Infect 1995;30(2:8593.
313.Bueno Cavanillas ARodriguez-Contreras R, Delgado Rodriguez M, Moreno Abril O, Lopez Gigosos R, Guillen Solvas J, et al. Preoperative stay as a risk factor for nosocomial infection. Eur J Epidemiol 1991;7(6:670–6.
314.Favero MS, Bond W. Sterilization, disinfection, and antisepsis in the hospital. In: Balows AHausier WJ Jr, Herrmann KL, Isenberg HD, Shadomy HJ, eds. Manual of Clinical Microbiology. 5th ed. Washington (DC): American Society of Microbiology; 1991. p. 183200.
315.U.S. Department of Labor, Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens; final rule (29 CFR Part 1910.1030). Federal Register 1991;56:64004182.
316.Rudnick JR, Beck-Sague CM, Anderson RL, Schabie C, Miller JM, Jarvis WR. Gram-negative bacteremia in open-heart-surgery patients traced to probable tap-water contamination of pressure-monitoring equipment. Infect Control Hosp Epidemiol 1996;17(5:281–5.
317.Centers for Disease Control. Postsurgical infections associated with nonsterile implantable devices. MMWR Morb Mortal Wkly Rep 1992;41(15):263.
318.Soto LE, Bobadilla M, Villalobos Y, Sifuentes J, Avelar J, Arieta M, et al. Post-surgical nasal cellulitis outbreak due to Mycobacterium chelonae. J Hosp Infect 1991;19(2:99106.
319.Favero MS, Manian FAIs eliminating flash sterilization practical? Infect Control Hosp Epidemiol 1993;14(8:479–80.
320.American Society for Healthcare Central Service Personnel. Recommended practices for central service. Section one, continuous quality improvement. Chicago: American Hospital Association; 1993.
321.Association for the Advancement of Medical Instrumentation. Flash sterilization: steam sterilization of patient care items for immediate use (ANSI/AAMI ST37-1996). Arlington (VA): Association for the Advancement of Medical Instrumentation; 1996.
322.Rutala WAGergen MF, Weber DJ. Evaluation of a rapid readout biological indicator for flash sterilization with three biological indicators and three chemical indicators. Infect Control Hosp Epidemiol 1993;14(7:390–4.
323.Vesley D, Langholz AC, Rohlfing SR, Foltz WE. Fluorimetrie detection of a Bacillus stearothermophilus spore-bound enzyme, alpha-D-glucosi-dase, for rapid indication of flash sterilization failure. Appi Environ Microbiol 1992;58:717–9.
324.Rutala WA, Jones SM, Weber DJ. Comparison of a rapid readout biological indicator for steam sterilization with four conventional biological indicators and five chemical indicators. Infect Control Hosp Epidemiol 1996;17:423–8.
325.Vesley D, Nellis MA, Allwood PB. Evaluation of a rapid readout biological indicator for 121 degrees C gravity and 132 degrees C vacuum-assisted steam sterilization cycles. Infect Control Hosp Epidemiol 1995;16:281–6.
326.Smith RF. What is the purpose of the scrub suit? [letter]. AORN J 1980;31(5):769.
327.Dineen PThe role of impervious drapes and gowns preventing surgical infection. Clin Orthop 1973;96:210–2.
328.Ha'eri GB, Wiley AM. The efficacy of standard surgical face masks: an investigation using “tracer particles.” Clin Orthop 1980;148:160–2.
329.Moylan JA, Fitzpatrick KT, Davenport KE. Reducing wound infections. Improved gown and drape barrier performance. Arch Surg 1987;122:152–7.
330.Moylan JA, Balish E, Chan J. Intraoperative bacterial transmission. Surg Forum 1974;25:2930.
331.Copp G, Mailhot CB, Zalar M, Slezak L, Copp AJ. Covergowns and the control of operating room contamination. Nurs Res 1986;35:263–8.
332.Beck WC. The surgical mask: another ‘sacred cow’? AORN J 1992;55:955–7.
333.Mitchell NJ, Hunt S. Surgical face masks in modern operating rooms— a costly and unnecessary ritual? J Hosp Infect 1991;18:239–42.
334.Tunevall TG, Jorbeck H. Influence of wearing masks on the density of airborne bacteria in the vicinity of the surgical wound. Eur J Surg 1992;158(5:263–6.
335.Tunevall TG. Postoperative wound infections and surgical face masks: a controlled study. World J Surg 1991;15:383–8.
336.Orr NW. Is a mask necessary in the operating theatre? Ann R Coll Surg Engl 1981;63(6:390–2.
337.Lee JT. Making surgical care better: hard work, small gains [editorial]. Infect Control Hosp Epidemiol 1997;18:68.
338.Jarvis WR, Bolyard EA, Bozzi CJ, Burwen DR, Dooley SW, Martin LS, et al. Respirators, recommendations, and regulations: the controversy surrounding protection of health care workers from tuberculosis. Ann Intern Med 1995;122:142–6.
339.Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Protect yourself against tuberculosis: a respiratory protection guide for health care workers (Publication No. 96-102). Cincinnati: Department of Health and Human Services (NIOSH); 1995.
340.Humphreys H, Marshall RJ, Ricketts VE, Russell AJ, Reeves DS. Theatre over-shoes do not reduce operating theatre floor bacterial counts. J Hosp Infect 1991;17:117–23.
341.Weightman NC, Banfield KR. Protective over-shoes are unnecessary in a day surgery unit. J Hosp Infect 1994;28:13.
342.Whyte W, Hambraeus A, Laurell G, Hoborn J. The relative importance of routes and sources of wound contamination during general surgery. I. Non-airborne. J Hosp Infect 1991;18(2:93107.
343.Dodds RD, Guy PJ, Peacock AM, Duffy SR, Barker SG, Thomas MH. Surgical glove perforation. Br J Surg 1988;75(10:966–8.
344.Tokars JI, Culver DH, Mendelson MH, Sloan EP, Farber BF, Fligner DJ, et al. Skin and mucous membrane contacts with blood during surgical procedures: risk and prevention. Infect Control Hosp Epidemiol 1995;16:703–11.
345.Short LJ, Bell DM. Risk of occupational infection with blood-borne pathogens in operating and delivery room settings. Am J Infect Control 1993;21:343–50.
346.Garibaldi RA, Maglio S, Lerer T, Becker D, Lyons R. Comparison of nonwoven and woven gown and drape fabric to prevent intraoperative wound contamination and postoperative infection. Am J Surg 1986;152(5:505–9.
347.Muller W, Jiru P, Mach RPolaschek F, Fasching W. The use of disposable draping materials in the operating room and its effect on the postoperative wound infection rate. Wein Klin Wochenschr 1989;101: 837–42.
348.Smith JW, Nichols RL. Barrier efficiency of surgical gowns. Are we really protected from our patients' pathogens? Arch Surg 1991;126(6): 756–63.
349.Artz CP, Conn JH, Howard HS. Protection of the surgical wound with a new plastic Om JAMA 1960;174(14:18658.
350.Chiu KY, Lau SK, Fung B, Ng KH, Chow SP. Plastic adhesive drapes and wound infection after hip fracture surgery. Aust N Z J Surg 1993;63(10:798801.
351.American Society for Testing Materials. Standard Test Method for Resistance of Materials Used in Protective Clothing to Penetration by Synthetic Blood. American Society for Testing Materials 1998;F167098.
352.American Society for Testing Materials. Standard Test Method for Resistance of Materials Used in Protective Clothing to Penetration by Blood-borne Pathogens Using Phi-Xl 74 Bacteriophage Penetration as a Test System. American Society for Testing Materials 1997; F1671976.
353.McCullough EAMethods for determining the barrier efficacy of surgical gowns. Am J Infect Control 1993;21:368–74.
354.Lewis JABrown PL. Breaking the comfort barrier in impervious gowns. Surgical Services Management 1998;4(2:2938.
355.Granzow JW, Smith JW, Nichols RL, Waterman RS, Muzik AC. Evaluation of the protective value of hospital gowns against blood strike-through and methicillin-resistant Staphylococcus aureus penetration Am J Infect Control 1998;26:8593.
356.Walter CW, Kundsin RB, Harding AL, Page LK. The infecter on the surgical team. Clin Neurosurg 1966;14:361–79.
357.Payne RW. Severe outbreak of surgical sepsis due to Staphylococcus aureus of unusual type and origin. Br Med J 1967;4:1720.
358.Centers for Disease Control. Hospital outbreak of streptococcal wound infection—Utah. MMWR Morb Mortal Wkly Rep 1976;25:141.
359.Herwaldt LAPottinger J, Coffin SANosocomial infections associated with anesthesia. In: Mayhall CG, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1996. p. 655–75.
360.Bennett SN, McNeil MM, Bland LAArduino MJ, Villarino ME, Perrotta DM, et al. Postoperative infections traced to contamination of an intravenous anesthetic, propofol. N Engl J Med 1995;333:147–54.
361.Froggatt JW, Dwyer DM, Stephens MA. Hospital outbreak of hepatitis C in patients undergoing electroconvulsive therapy [abstract]. Program and Abstracts of the 31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago 1991;157:(347).
362.Centers for Disease Control. Postsurgical infections associated with an extrinsically contaminated intravenous anesthetic agent—California, Illinois, Maine, and Michigan, 1990. MMWR Morb Mortal Wkly Rep 1990;39:426-7, 433.
363.Daily MJ, Dickey JB, Packo KH. Endogenous Candida endophthalmitis after intravenous anesthsia with propofol. Arch Ophthalmol 1991;109:10814.
364.Villarino ME, McNeill MM, Hall WN. Postsurgical infections associated with an extrinsically contaminated intravenous anesthetic agent [abstract]. Program and Abstracts of the 31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago 1991;156:(346).
365.American Association of Nurse Anesthetists. Infection Control Guide. Park Ridge (IL): American Association of Nurse Anesthetists; 1993.
366.American Society of Anesthesiologists. Recommendations for Infection Control for the Practice of Anesthesiology. Park Ridge (IL): American Society of Anesthesiologists; 1992.
367.Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231–43.
368.Zacharias A, Habib RH. Delayed primary closure of deep sternal wound infections. Tex Heart Inst J 1996;23(3:211–6.
369.Smilanich RP, Bonnet I, Kirkpactrick JRContaminated wounds: the effect of initial management on outcome. Am Surg 1995;61(5:427–30.
370.Blomstedt GC. Infections in neurosurgery: a randomized comparison between silk and polyglycolic acid. Acta Neurochir (Wien) 1985;76:90–3.
371.Scher KS, Bernstein JM, Jones CW. Infectivity of vascular sutures. Am Surg 1985;51:577–9.
372.Durdey P, Bucknall TE. Assessment of sutures for use in colonic surgery: an experimental study. J R Soc Med 1984;77:472–7.
373.Chu CC, Williams DEEffects of physical configuration and chemical structure of suture materials on bacterial adhesion. A possible link to wound infection. Am J Surg 1984;147:197204.
374.Askew ARA comparison of upper abdominal wound closure with monofilament nylon and polyglycolic acid. Aust N Z J Surg 1983;53:353–6.
375.Kapadia CR, Mann JB, McGeehan D, Jose Biglin JE, Waxman BP, Dudley HABehaviour of synthetic absorbable sutures with and without synergistic enteric infection. Eur Surg Res 1983;15:6772.
376.Bucknall TE, Teare L, Ellis H. The choice of a suture to close abdominal incisions. Eur Surg Res 1983;15:5966.
377.Bucknall TE. Factors influencing wound complications: a clinical and experimental study. Ann R Coll Surg Engl 1983;65:71–7.
378.Varma S, Lumb WV, Johnson LW, Ferguson HL. Further studies with polyglycolic acid (Dexon) and other sutures in infected experimental wounds. Am J Vet Res 1981;42:571–4.
379.Bucknall TE, Ellis H. Abdominal wound closure—a comparison of monofilament nylon and polyglycolic acid. Surgery 1981;89:672–7.
380.Dougherty SH, Simmons RL. The biology and practice of surgical drains. Part II. Curr Probi Surg 1992;29(9:635730.
381.Cruse PJE. Wound infections: epidemiology and clinical characteristics in surgical infectious disease. In: Howard RJ, Simmons RL, eds. Surgical Infectious Diseases.> 2nd ed. Norwalk (CT): Appleton and Lange; 1988. p. 319–29.
382.Drinkwater CJ, Neil MJ. Optimal timing of wound drain removal following total joint arthroplasty. J Arthroplasty 1995;10(2:185–9.
383.Tollofsrud SG, Gundersen Y, Andersen R. Perioperative hypothermia. Acta Anaesthesiol Scand 1984;28:511–5.
384.Sessler DI. Mild perioperative hypothermia. N Engl J Med 1997;336(24:17307.
385.Kurz ASessler DI, Lenhardt RPerioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med 1996;334(19:120915.
386.Hunt TKHopf HW. Wound healing and wound infection. What surgeons and anesthesiologists can do. Surg Clin North Am 1997;77: 587606.
387.Wenisch C, Narzt E, Sessler DI, Parschalk B, Lenhardt R, Kurz A, et al. Mild intraoperative hypothermia reduces production of reactive oxygen intermediates by polymorphonuclear leukocytes. Anesth Analg 1996;82:810–6.
388.Jonsson K, Hunt TK, Mathes SJ. Oxygen as an isolated variable influences resistance to infection. Ann Surg 1988;208:783–7.
389.Jonsson K, Jensen JAGoodson WH 3d, West JM, Hunt TKAssessment of perfusion in postoperative patients using tissue oxygen measurements. Br J Surg 1987;74:263–7.
390.Chang N, Goodson WH 3d, Gottrup F, Hunt TK. Direct measurement of wound and tissue oxygen tension in postoperative patients. Ann Surg 1983;197:470–8.
391.Knighton DRHalliday B, Hunt TKOxygen as an antibiotic. The effect of inspired oxygen on infection. Arch Surg 1984;119:199204.
392.Ikeda T, Tayefeh F, Sessler DI, Kurz A, Plattner 0, Petschnigg C, et al. Local radiant heating increases subcutaneous oxygen tension. Am J Surg 1998;175:33–7.
393.DuMortier JJ. The resistance of healing wounds to infection. Surg Gynecol Obstet 1933;56:762–6.
394.Morain WD, Colen LB. Wound healing in diabetes mellitus. Clin Plast Surg 1990;17:493501.
395.American Hospital Association. Infection Control in the Hospital. Chicago: American Hospital Association; 1979. p. 161–2.
396.Castle M, Ajemian E. Hospital Infection Control: Principles and Practice. New York: John Wiley & Sons; 1987. p. 114–6.
397.Centers for Disease Control. Isolation Techniques for Use in Hospitals. Washington (DC): Public Health Service Publication; 1970.
398.Kravitz M. Outpatient wound care. Crit Care Nurs Clin North Am 1996;8(2:217–33.
399.Condon RE, Schulte WJ, Malangoni MA, Anderson-Teschendorf MJ. Effectiveness of a surgical wound surveillance program. Arch Surg 1983;118:303–7.
400.Haley RW, Culver DH, White JW, Morgan WM, Emori TG, Munn VEThe efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182205.
401.Lennard ES, Hargiss CO, Schoenknecht FD. Postoperative wound infection surveillance by use of bacterial contamination catgeories. Am J Infect Control 1985;13:147–53.
402.Olson MM, Lee JT Jr.Continuous, 10-year wound infection surveillance. Results, advantages, and unanswered questions. Arch Surg 1990;125:794803.
403.Olson M, O'Connor MO, Schwartz ML. Surgical wound infections. A 5-year prospective study of 20,193 wounds at the Minneapolis VA Medical Center. Ann Surg 1984;199:253–9.
404.Weigelt JA. Risk of wound infections in trauma patients. Am J Surg 1985;150:782–4.
405.Weigelt JA, Haley RW, Seibert C. Factors which influence the risk of wound infection in trauma patients. J Trauma 1987;27(7:774–81.
406.Anonymous. New classification of physical status. Anesthesiology 1963;24:111.
407.Owens WD. ASA physical status classification: a study on consistency of ratings. Anesthesiology 1978;49:239–43.
408.National Nosocomial Infections Surveillance System. Nosocomial infection rates for interhospital comparison: limitations and possible solutions. A report from tbe National Nosocomial Infections Surveillance (NNIS) System. Infect Control Hosp Epidemiol 1991;12: 609–21.
409.Cardo DM, Falk PS, Mayhall CG. Validation of surgical wound surveillance. Infect Control Hosp Epidemiol 1993;14:211–5.
410.Horan T, Gaynes R, Culver D, National Nosocomial Infections Surveillance (NNIS) System, CDC. Development of predictive risk factors for nosocomial surgical site infections (SSI) [abstract]. Infect Control Hosp Epidemiol 1994;15(Suppl):P46(M72).
411.Nichols RL, Smith JW, Klein DB, Trunkey DD, Cooper RH, Adinolfi MF, et al. Risk of infection after penetrating abdominal trauma. N Engl J Med 1984;311:106570.
412.Nichols RL, Smith JW, Robertson GD, Muzik AC, Pearce P, Ozmen V, et al. Prospective alterations in therapy for penetrating abdominal trauma. Arch Surg 1993;128:5564.
413.Horan TC, Culver DH, Gaynes RP, National Nosocomial Infections Surveillance (NNIS) System. Results of a multicenter study on risk factors for surgical site infections (SSI) following C-section (CSEC) [abstract]. Am J Infect Control 1996;24:84.
414.Roy MC, Herwaldt LA, Embrey R, Kuhns KWenzel RP, Perl TM. Does the NNIS risk index (NPJ) predict which patients develop wound infection (SWI) after cardiothoracic (CT) surgery? [abstract]. 34th Interscience Conference on Antimicrobial Agents and Chemotherapy 1994; Orlando, FL: 196.
415.Lee TC. Surveillance in acute care and nonacute care settings: current issues and concepts. Am J Infect Control 1997;25(2:121–4.
416.Lee JT. Wound infection surveillance. Infect Dis Clin North Am 1992;6(3:643–56.
417.Mead PB, Pories SE, Hall EVacek PM, Davis JH Jr, Gamelli RL. Decreasing the incidence of surgical wound infections. Validation of a surveillance-notification program. Arch Surg 1986;121:458–61.
418.Kerstein M, Flower M, Harkavy LM, Gross PASurveillance for postoperative wound infections: practical aspects. Am Surg 1978;44: 2104.
419.Poulsen KB, Jepsen OB. Failure to detect a general reduction of surgical wound infections in Danish hospitals. Dan Med Bull 1995;42:485–8.
420.Haley RW, Schaberg DRMcClish DK, Quade D, Crossley KB, Culver DH, et al. The accuracy of retrospective chart review in measuring nosocomial infection rates. Results of validation studies in pilot hospitals. Am J Epidemiol 1980;111(5):516–33.
421.Mulholland SG, Creed J, Dierauf LABruun JN, Blakemore WS. Analysis and significance of nosocomial infection rates. Ann Surg 1974;180:827–30.
422.Wenzel RP, Osterman CAHunting KJ, Gwaltney JM Jr.Hospital-acquired infections. I. Surveillance in a university hospital. Am J Epidemiol 1976;103:251–60.
423.Simchen E, Shapiro JM, Michel J, Sacks T. Multivariate analysis of determinants of postoperative wound infection: a possible basis for intervention. Rev Infect Dis 1981;3(4:678–82.
424.Collier C, Miller DRBorst M. Community hospital surgeon-specific infection rates. Infect Control 1987;8(6);249–54.
425.Ehrenkranz NJ, Shultz JM, Richter EL. Recorded criteria as a “gold standard” for sensitivity and specificity estimates of surveillance of nosocomial infection: a novel method to measure job performance. Infect Control Hosp Epidemiol 1995;16:697702.
426.Hirschhorn LR, Currier JS, Platt R. Electronic surveillance of antibiotic exposure and coded discharge diagnoses as indicators of postoperative infection and other quality assurance measures. Infect Control Hosp Epidemiol 1993;14:21–8.
427.Simchen E, Wax Y, Pevsner B, Erdal M, Michel j; Modan M, et al. The Israeli Study of Surgical Infections (ISSI): I. Methods for developing a standardized surveillance system for a multicenter study of surgical infections. Infect Control Hosp Epidemiol 1988;9(6:232–40.
428.Burns SJ, Dippe SE. Postoperative wound infections detected during hospitalization and after discharge in a community hospital. Am J Infect Control 1982;10(2:60–5.
429.Laxson LB, Blaser MJ, Parkhurst SM. Surveillance for the detection of nosocomial infections and the potential for nosocomial outbreaks. Am J Infect Control 1984;12(6:318–24.
430.Mertens R, Jans C, Kurz X. A computerized nationwide network for nosocomial infection surveillance in Belgium. Infect Control Hosp Epidemiol 1994;15:171–9.
431.Ehrenkranz NJ. Surgical wound infection occurrence in clean operations; risk stratification for interhospital comparisons. Am J Med 1981;(70):909–14.
432.Baker C, Luce J, Chenoweth C, Friedman C. Comparison of case-finding methodologies for endometritis after cesarean section. Am J Infect Control 1995;23:2733.
433.Gaynes RP, Horan TC. Surveillance of nosocomial infections. In: Mayhall CG, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1996. p. 1017–31.
434.Horan TC, Emori TG. Definitions of key terms used in the NNIS system. Am J Infect Control 1997;25:112–6.
435.Polk BF, Tager IB, Shapiro M, Goren-White B, Goldstein P, Schoenbaum SC. Randomised clinical trial of perioperative cefazolin in preventing infection after hysterectomy. Lancet 1980;1:437–41.
436.Salem RJ, Johnson J, Devitt P. Short term metronidazole therapy contrasted with povidone-iodine spray in the prevention of wound infection after appendicectomy. Br J Surg 1979;66:430–1.
437.Walsh AL, Roberts FJ, Bryce EAPost-discharge surveillance of surgical wound infections [letter]. Can J Inf ed Control 1996;11(1):29.
438.Brown RB, Bradley S, Opitz E, Cipriani D, Pieczarka R, Sands M. Surgical wound infections documented after hospital discharge. Am J Infect Control 1987;15:54–8.
439.Rosendorf LL, Octavio J, Estes JEEffect of methods of postdischarge wound infection surveillance on reported infection rates. Am J Infect Control 1983;11(6):226–9.
440.Ferraz EM, Ferraz AACoelho HS, Pereira Viana V, Sobral SM, Vasconcelos MD, et al. Postdischarge surveillance for nosocomial wound infection: does judicious monitoring find cases? Am J Infect Control 1995;23:2904.
441.Andenaes K, Amland PF, Lingaas E, Abyholm F, Samdai F, Giercksky KE. A prospective, randomized surveillance study of postoperative wound infections after plastic surgery: a study of incidence and surveillance methods. Plast Reconstr Surg 1995;96(4:948–56.
442.Keeling NJ, Morgan MW. Inpatient and post-discharge wound infections in general surgery. Ann R Coll Surg Engl 1995;77:245–7.
443.Manian FA, Meyer L. Adjunctive use of monthly physician questionnaires for surveillance of surgical site infections after hospital discharge and in ambulatory surgical patients: report of a seven-year experience. Am J Infect Control 1997;25:3904.
444.Manian FA, Meyer L. Comparison of patient telephone survey with traditional surveillance and monthly physician questionnaires in monitoring surgical wound infections. Infect Control Hosp Epidemiol 1993;14:216–8.
445.Reimer K, Gleed C, Nicolle LE. The impact of postdischarge infection on surgical wound infection rates. Infect Control 1987;8(6:237–40.
446.Sands K, Vineyard G, Platt R. Surgical site infections occuring after hospital discharge. J Infect Dis 1996;173:963–70.
447.Weigelt JA, Dryer D, Haley RW. The necessity and efficiency of wound surveillance after discharge. Arch Surg 1992;127:7782.
448.Gravel-Tropper D, Oxley C, Memish Z, Garber GE. Underestimation of surgical site infection rates in obstetrics and gynecology. Am J Infect Control 1995;23:22–6.
449.Taylor S, Pearce P, McKenzie M, Taylor GD. Wound infection in total joint arthroplasty: effect of extended wound surveillance on wound infection rates. Can J Surg 1994;37(3:217–20.
450.Hulton IJ, Olmsted RN, Treston-Aurand J, Craig CP. Effect of postdischarge surveillance on rates of infectious complications after cesarean section. Am J Infect Control 1992;20:198201.
451.Law DJ, Mishriki SF, Jeffery PJ. The importance of surveillance after discharge from hospital in the diagnosis of postoperative wound infection. Ann R Coll Surg Engl 1990;72:207–9.
452.Donovan IA, Ellis D, Gatehouse D, Little G, Grimley R, Armistead S, et al. One-dose antibiotic prophylaxis against wound infection after appen-dicectomy: a randomized trial of clindamycin, cefazolin sodium and a placebo. Br J Surg 1979;66:193–6.
453.Bates T, Down RH, Houghton MC, Lloyd GJ. Topical ampicillin in the prevention of wound infection after appendicectomy. Br J Surg 1974;61:489–92.
454.Centers for Disease Control and Prevention. Evaluation of blunt suture needles in preventing percutaneous injuries among health-care workers during gynecologic surgical procedures, New York City, March 1993-June 1994. MMWR Morb Mortal Wkly Rep 1997;46(2:25–9.
455.Fanning C, Johnston BLMacDonald S, LeFort-Jost S, Dockerty E. Postdischarge surgical site infection surveillance. Can J Infect Control 1995;10(3:75–9.
456.Holbrook KF, Nottebart VF, Hameed SR, Platt RAutomated postdischarge surveillance for postpartum and neonatal nosocomial infections. Am J Med 1991;91 (Suppl 3B):125S30S.
457.Zoutman D, Pearce P, McKenzie M, Taylor G. Surgical wound infections occuring in day surgery patients. Am J Infect Control 1990;18: 277–82.
458.Seaman M, Lammers R. Inability of patients to self-diagnose wound infections. J Emerg Med 1991;9:215–9.
459.Goulbourne IA, Ruckley CV. Operations for hernia and varicose veins in a day-bed unit. Br Med J 1979;2:712–4.
460.Garvey JM, Buffenmyer C, Rycheck RR, Yee R, McVay J, Harger JH. Surveillance for postoperative infections in outpatient gynecologic surgery. Infect Control 1986;7(2:54–8.
461.Flanders E, Hinnant JR. Ambulatory surgery postoperative wound surveillance. Am J Infect Control 1990;18(5:336–9.
462.Gentry LO, Zeluff BJ, Cooley DA. Antibiotic prophylaxis in open-heart surgery: a comparison of cefamandole, cefuroxime, and cefazolin. Ann Thorac Surg 1988;46:167–71.
463.Maki DG, Bohn MJ, Stolz SM, Kroncke GM, Archer CW, Myerowitz PD. Comparative study of cefazolin, cefamandole, and vancomycin for surgical prophylaxis in cardiac and vascular operations. A double-blind randomized trial. J Thorac Cardiovasc Surg 1992;104:142334.
464.Haines SJ, Walters CC. Antibiotic prophylaxis for cerebrospinal fluid shunts: a metanalysis. Neurosurgery 1994;34(1:8792.
465.Langley JM, LeBlanc JC, Drake J, Milner REfficacy of antimicrobial prophylaxis in placement of cerebrospinal fluid shunts: meta-analysis. Clin Infect Dis 1993;17:98103.
466.Starr MB, Lally JM. Antimicrobial prophylaxis for ophthalmic surgery. Surv Ophthalmol 1995;39:485501.
467.Gatell JM, Riba J, Lozano MLMana J, Ramon RGarcia Sanmiguel J. Prophylactic cefamandole in orthopaedic surgery. J Bone Joint Surg Am 1984;66:121922.
468.Kent KC, Bartek S, Kuntz KM, Anninos E, Skillman JJ. Prospective study of wound complications in continuous infrainguinal incisions after lower limb arterial reconstruction: incidence, risk factors, and cost Surgery 1996;119(4:378–83.
469.Wymenga AB, van Horn JR, Theeuwes A, Muytjens HL, Slooff TJ. Perioperative factors associated with septic arthritis after arthroplasty. Prospective multicenter study of 362 knee and 2,651 hip operations. Acta Orthop Scand 1992;63(6:665–71.
470.Stambough JL, Beringer D. Postoperative wound infections complicating adult spine surgery. J Spinal Disord 1992;5(3):277–85.
471.Trippel SB. Antibiotic-impregnated cement in total joint arthroplasty. J Bone Joint Surg Am 1986;68A;1297–302.
472.Nungu KS, Olerud C, Rehnberg LLarsson S, Nordell P, Allvin I, et al. Prophylaxis with oral Cefadroxil versus intravenous cefuroxime in trochanteric fracture surgery. A clinical multicentre study. Arch Orthop Trauma Surg 1995;114(6:303–7.
473.Norden CW. Antibiotic prophylaxis in orthopedic surgery. Rev Infect Dis 1991;13(Suppl 10):S842–6.
474.Aznar RMateu M, Miro JM, Gatell JM, Gimferrer JM, Aznar E, et al. Antibiotic prophylaxis in non-cardiac thoracic surgery: cefazolin versus placebo. Eur J Cardiothorac Surg 1991;5:515–8.
475.Cant PJ, Smyth S, Smart DO. Antibiotic prophylaxis is indicated for chest stab wounds requiring closed tube thoracostomy. Br J Surg 1993;80:464–6.
476.Pitt HA, Postier RG, MacGowan AW, Frank LW, Surmak AJ, Sitzman JV, et al. Prophylactic antibiotics in vascular surgery. Topical, systemic, or both? Ann Surg 1980;192:356–64.
477.Kaiser AB, Clayson KR, Mulherin JL Jr, Roach AC, Allen TR, Edwards WH, et al. Antibiotic prophylaxis in vascular surgery. Ann Surg 1978;188:283–9.
478.Bauer T, Vennits B, Holm B, Hahn-Pedersen J, Lysen D, Galatius H, et al. Antibiotic prophylaxis in acute nonperforated appendicitis. The Danish Multicenter Study Group II. Ann Surg 1989;209:307–11.
479.Skipper D, Corder AP, Karran SJ. A randomized prospective study to compare ceftizoxime with cephradine as single dose prophylaxis in elective cholecystectomy. J Hosp Infect 1991;17:303–6.
480.Kaufman Z, Engelberg M, Eliashiv A, Reiss RSystemic prophylactic antibiotics in elective biliary surgery. Arch Surg 1984;119:10024.
481.Grant MD, Jones RC, Wilson SE, Bombeck CT, Flint LM, Jonasson O, et al. Single dose cephalosporin prophylaxis in high-risk patients undergoing surgical treatment of the biliary tract. Surg Gynecol Obstet 1992;174:347–54.
482.Lewis RT, Goodall RG, Marien C, Park M, Lloyd-Smith W, Wiegand FM. Biliary bacteria, antibiotic use, and wound infection in surgery of the gallbladder and common bile duct. Arch Surg 1987;122:44–7.
483.Saltzstein EC, Mercer LC, Peacock JB, Dougherty SH. Outpatient open cholecystectomy. Surg Gynecol Obstet 1992;174(3:173–5.
484.Meijer WS, Schmitz PI, Jeekel J. Meta-analysis of randomized, controlled clinical trials of antibiotic prophylaxis in biliary tract surgery. Br J Surg 1990;77:283–90.
485.Kaiser AB, Herrington JL Jr, Jacobs JKMulherin JL Jr, Roach AC, Sawyers JL. Cefoxitin versus erythromycin, neomycin, and cefazolin in colorectal operations. Importance of the duration of the surgical procedure. Ann Surg 1983;198:525–30.
486.Schoetz DJ Jr, Roberts PL, Murray JJ, Coller JA, Veidenheimer MC. Addition of parenteral cefoxitin to regimen of oral antibiotics for elective colorectal operations. A randomized prospective study. Ann Surg 1990;212:209–12.
487.Edmondson HT, Passing JP. Prophylactic antibiotics in colon surgery. Arch Surg 1983;118:227–31.
488.Wapnick S, Guinto RReizis I, LeVeen HH. Reduction of postoperative infection in elective colon surgery with preoperative administration of kanamycin and erythromycin. Surgery 1979;85:317–21.
489.Washington JA 2d, Dearing WH, Judd ES, Elveback LR. Effect of preoperative antibiotic regimen on development of infection after intestinal surgery. Prospective, randomized, double-blind study. Ann Surg 1974;108:567–72.
490.Maki DG, Aughey DRComparative study of cefazolin, cefoxitin, and ceftizoxime for surgical prophylaxis in colo-rectal surgery. J Antimicrob Chemother 1982;10(Suppl C):281–7.
491.Rotman N, Hay JM, Lacaine F, Fagniez PL, The Association de Recherche en Chirurgie Cooperative Group. Prophylactic antibiothera-py in abdominal surgery. First- vs third-generation cephalosporins. Arch Surg 1989;124:323–7.
492.Lewis RT, Allan CM, Goodall RG, Marien C, Park M, Lloyd-Smith W, et al. Cefamandole in gastroduodenal surgery: a controlled, prospective, randomized, double-blind study. Can J Surg 1982;25(5:561–3.
493.McArdle CS, Morran CG, Anderson JRPettit L, Gemmell CG, Sleigh JD, et al. Oral ciprofloxacin as prophylaxis in gastroduodenal surgery. J Hosp Infect 1995;30(3:211–6.
494.Grandis JRVickers RM, Rihs JD, Yu VL, Johnson JT, Efficacy of topical amoxicillin plus clavulanate/ticarcillin plus clavulanate and clindamycin in contaminated head and neck surgery: effect of antibiotic spectra and duration of therapy. J Infect Dis 1994;170:729–32.
495.Johnson JT, Yu VL, Myers EN, Wagner RLAn assessment of the need for gram-negative bacterial coverage in antibiotic prophylaxis for oncological head and neck surgery. J Infect Dis 1987;155(2:331–3.
496.Elledge ES, Whiddon RG Jr, Fraker JT, Stambaugh KI. The effects of topical oral clindamycin antibiotic rinses on the bacterial content of saliva on healthy human subjects. Otolaryngol Head Neck Surg 1991;105:836–9.
497.Johnson JT, Yu VLMyers EN, Wagner RL, Sigler BACefazolin vs mox-alactam? A double-blind randomzied trial of cephalosporins in head and neck surgery. Arch Otolaryngol Head Neck Surg 1986;112:151–3.
Association of Operating Room Nurses. Standards, Recommended Practices, Guidelines. Denver: Association of Operating Room Nurses; 1999.
Larson ELAPIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251–69.
Association of Operating Room Nurses. Recommended practices for skin preparation of patients. AORN J 1996;64:813–6.
Rutala WAAPIC guideline for selection and use of disinfectants. Am J Infect Control 1990;18:99117.
Favero MS, Bond W. Sterilization, disinfection, and antisepsis in the hospital. In: Balows A, Hausier WJ Jr, Herrmann KL, Isenberg HD, Shadomy HJ, eds. Manual of Clinical Microbiology. 5th ed. Washington (DC): American Society for Microbiology; 1991. p. 183200.
Association for the Advancement of Medical Instrumentation. Flash sterilization: steam sterilization of patient care items for immediate use (ANSI/AAMI ST37-1996). Arlington (VA): Association for the Advancement of Medical Instrumentation; 1996.
American Institute of Architects Committee. Guidelines for design and construction of hospital and health care facilities. Washington (DC): American Institute of Architects Press; 1996.
Association for the Advancement of Medical Instrumentation. Selection of surgical gowns and drapes in health care facilities (AAMITIR No. 11-1994). Arlington (VA): Association for the Advancement of Medical Instrumentation; 1994.
Platt RGuidelines for perioperative antibiotic prophylaxis. In: Abrutyn E, Goldmann DAScheckler WE, eds. Saunders Infection Control Reference Service. Philadelphia: W.B. Saunders Co; 1997. p. 229–34.
Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. NEngl J Med 1992;326:281–6.
Wong ES. Surgical site infections. In: Mayhall CG, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1996. p. 154–74.
Hochberg J, Murray GF. Principles of operative surgery: antisepsis, technique, sutures, and drains. In: Sabiston DC Jr, ed. Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 15th ed. Philadelphia: W.B. Saunders Co; 1997. p. 253–63.
Roy MC. Surgical-site infections after coronary artery bypass graft surgery: discriminating site-specific risk factors to improve prevention efforts. Infect Control Hosp Epidemiol 1998;19:229–33.
Herwaldt LA, Pottinger J, Coffin SANosocomial infections associated with anesthesia. In: Mayhall CG, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1996. p. 655–75.
Gaynes RP, Horan TC. Surveillance of nosocomial infections. In: Mayhall CG, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1996. p. 1017–31.
Roy MC, Perl TM. Basics of surgical-site infection surveillance. Infect Control Hosp Epidemiol 1997;18:659–68.
Lee JT. Surgical wound infections: surveillance for quality improvement In: Fry DE, ed. Surgical Infictions. Boston: Little, Brown and Co; 1995. p. 145–59.
Meier PAInfection control issues in same-day surgery. In: Wenzel RP, ed. Prevention and Control of Nosocomial Infections. 3rd ed. Baltimore: Williams & Wilkins; 1997. p. 261–82.
Burke JRInfections of cardiac and vascular prostheses. In: Bennett JV, Brachman PS, eds. Hospital Infections. 4th ed. Philadelphia: Lippincott Raven; 1998. p. 599612.
Lew DP, Waldvogel FAInfections of skeletal prostheses. In: Bennett JV, Brachman PS, eds. Hospital Infections. 4th ed. Philadelphia: Lippincott Raven; 1998. p. 613–20.
Nafziger Da Saravolatz LD. Infection in implantable prosthetic devices. In: Wenzel RP, ed. Prevention and Control of Nosocomial Infections. 3rd ed. Baltimore: Williams & Wilkins; 1997. p. 889923.