Guideline for Prevention of Surgical Site Infection, 1999

American Journal of Infection Control - Tập 27 Số 2 - Trang 97-134 - 1999
Alicia J. Mangram1, Teresa Horan1, Michele L. Pearson1, Leah Christine Silver1, William R. Jarvis1
1Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services Atlanta, Georgia

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Garner, 1986, 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, 7, 193, 10.1017/S0195941700064080

Simmons, 1982, Guideline for prevention of surgical wound infections, Infect Control, 3, 185, 10.1017/S0195941700057131

Garner, 1993, The CDC Hospital Infection Control Practices Advisory Committee, Am J Infect Control, 21, 160, 10.1016/0196-6553(93)90009-S

Hecht, 1995, Creating greater efficiency in ambulatory surgery, J Clin Anesth, 7, 581, 10.1016/0952-8180(95)00136-0

Horwitz, 1998, Pediatric wound infections: a prospective multicenter study, Ann Surg, 227, 553, 10.1097/00000658-199804000-00017

Golub, 1998, Laparoscopic versus open appendectomy: a metaanalysis, J Am Coll Surg, 186, 545, 10.1016/S1072-7515(98)00080-5

Mayol, 1997, Risks of the minimal access approach for laparoscopic surgery: multivariate analysis of morbidity related to umbilical trocar insertion, World J Surg, 21, 529, 10.1007/PL00012281

Lacy, 1997, Postoperative complications of laparoscopic-assisted colectomy, Surg Endosc, 11, 119, 10.1007/s004649900311

Pagni, 1998, Serious wound infections after minimally invasive coronary bypass procedures, Ann Thorac Surg, 66, 92, 10.1016/S0003-4975(98)00353-1

The Southern Surgeons Club, 1991, A prospective analysis of 1518 laparoscopic cholecystectomies, N Engl J Med, 324, 1073, 10.1056/NEJM199104183241601

Centers for Disease Control and Prevention, 1997, National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1997, issued May 1997, Am J Infect Control, 25, 477, 10.1016/S0196-6553(97)90071-7

Food and Drug Administration, 1994, 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, 59, 31441

Centers for Disease Control and Prevention, 1997, Vital and Health Statistics, Detailed Diagnoses and Procedures,, Vol 127

Emori, 1993, An overview of nosocomial infections, including the role of the microbiology laboratory, Clin Microbiol Rev, 6, 428, 10.1128/CMR.6.4.428

Cruse, 1981, Wound infection surveillance, Rev Infect Dis, 4, 734, 10.1093/clinids/3.4.734

Cruse, 1980, The epidemiology of wound infection: a 10-year prospective study of 62,939 wounds, Surg Clin North Am, 60, 27, 10.1016/S0039-6109(16)42031-1

Martone, 1992, Incidence and nature of endemic and epidemic nosocomial infections, 577

Boyce, 1990, Hospital reimbursement patterns among patients with surgical wound infections following open heart surgery, Infect Control Hosp Epidemiol, 11, 89, 10.1086/646127

Poulsen, 1994, Estimated costs of postoperative wound infections. A case-control study of marginal hospital and social security costs, Epidemiol Infect, 113, 283, 10.1017/S0950268800051712

Vegas, 1993, Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization, Eur J Epidemiol, 9, 504

Albers, 1994, Cost effectiveness of preventive antibiotic administration for lowering risk of infection by 0.25%, Unfallchirurg, 97, 625

Horan, 1992, CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections, Infect Control Hosp Epidemiol, 13, 606, 10.1086/646436

Ehrenkranz, 1995, An apparent excess of operative site infections: analyses to evaluate false-positive diagnoses, Infect Control Hosp Epidemiol, 16, 712, 10.1086/647045

Taylor, 1990, Effect of surgeon’s diagnosis on surgical wound infection rates, Am J Infect Control, 18, 295, 10.1016/0196-6553(90)90228-K

SHEA, 1992, Consensus paper on the surveillance of surgical wound infections, Infect Control Hosp Epidemiol, 13, 599, 10.1086/646435

Nooyen, 1994, Prospective randomised comparison of single-dose versus multiple-dose cefuroxime for prophylaxis in coronary artery bypass grafting, Eur J Clin Microbiol Infect Dis, 13, 1033, 10.1007/BF02111823

Centers for Disease Control and Prevention, 1996, 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, Am J Infect Control, 24, 380, 10.1016/S0196-6553(96)90026-7

Schaberg, 1994, Resistant gram-positive organisms, Ann Emerg Med, 24, 462, 10.1016/S0196-0644(94)70185-7

Schaberg, 1991, Major trends in the microbial etiology of nosocomial infection, Am J Med, 91, 72S, 10.1016/0002-9343(91)90346-Y

Jarvis, 1995, Epidemiology of nosocomial fungal infections, with emphasis on Candida species, Clin Infect Dis, 20, 1526, 10.1093/clinids/20.6.1526

Centers for Disease Control, 1978, Nosocomial outbreak of Rhizopus infections associated with Elastoplast wound dressings—Minnesota, MMWR, 27, 33

Pearson, 1980, Clostridium perfringens wound infections associated with elastic bandages, JAMA, 244, 1128, 10.1001/jama.244.10.1128

Richet, 1991, A cluster of Rhodococcus (Gordona) bronchialis sternal-wound infections after coronary-artery bypass surgery, N Engl J Med, 324, 104, 10.1056/NEJM199101103240206

Wenger, 1998, Nocardia farcinica sternotomy site infections in patients following open heart surgery, J Infect Dis, 178, 1539, 10.1086/314450

Lowry, 1991, A cluster of Legionella sternal-wound infections due to postoperative topical exposure to contaminated tap water, N Engl J Med, 324, 109, 10.1056/NEJM199101103240207

Bassett, 1970, Wound infection with Pseudomonas multivorans: a water-borne contaminant of disinfectant solutions, Lancet, 1, 1188, 10.1016/S0140-6736(70)91783-6

Cruse, 1992, Surgical wound infection, 758

Altemeier, 1965, Surgical infection, 51

Krizek, 1975, Evolution of quantitative bacteriology in wound management, Am J Surg, 130, 579, 10.1016/0002-9610(75)90516-4

Elek, 1957, The virulence of Staphylococcus pyogenes for man: a study of problems with wound infection, Br J Exp Pathol, 38, 573

Noble, 1965, The production of subcutaneous staphylococcal skin lesions in mice, Br J Exp Pathol, 46, 254

James, 1961, Induction of staphylococcal infections in mice with small inocula introduced on sutures, Br J Exp Pathol, 42, 266

Henderson, 1996, Microbial/host interactions in health and disease: who controls the cytokine network?, Immunopharmacology, 35, 1, 10.1016/0162-3109(96)00144-0

Morrison, 1987, Endotoxins and disease mechanisms, Ann Rev Med, 38, 417, 10.1146/annurev.med.38.1.417

Demling, 1993, Multiple-organ dysfunction in the surgical patient: pathophysiology, prevention, and treatment, Curr Probl Surg, 30, 345, 10.1016/0011-3840(93)90054-K

Eiseman, 1977, Multiple organ failure, Surg Gynecol Obstet, 14, 323

Fry, 1980, Multiple system organ failure: the role of uncontrolled infection, Arch Surg, 115, 136, 10.1001/archsurg.1980.01380020006003

Kasper, 1986, Bacterial capsule—old dogmas and new tricks, J Infect Dis, 153, 407, 10.1093/infdis/153.3.407

Dellinger, 1997, Surgical infections and choice of antibiotics, 264

Goeau-Brissonniere, 1987, Experimental colonization of an expanded polytetrafluoroethylene vascular graft with Staphylococcus aureus: a quantitative and morphologic study, J Vasc Surg, 5, 743, 10.1016/0741-5214(87)90163-7

Bergamini, 1994, The natural history of bacterial biofilm graft infection, J Surg Res, 56, 393, 10.1006/jsre.1994.1062

Baddour, 1984, Production of experimental endocarditis by coagulase-negative staphylococci: variability in species virulence, J Infect Dis, 150, 721, 10.1093/infdis/150.5.721

Christensen, 1987, Phenotypic variation of Staphylococcus epidermidis slime production in vitro and in vivo, Infect Immun, 55, 2870, 10.1128/IAI.55.12.2870-2877.1987

Mayberry-Carson, 1984, Bacterial adherence and glycocalyx formation in osteomyelitis experimentally induced with Staphylococcus aureus, Infect Immun, 43, 825, 10.1128/IAI.43.3.825-833.1984

Mills, 1984, Exopolysaccharide production by viridans streptococci in experimental endocarditis, Infect Immun, 43, 359, 10.1128/IAI.43.1.359-367.1984

Kaebnick, 1987, The microbiology of explanted vascular prostheses, Surgery, 102, 756

Altemeier, 1968, Surgical considerations of endogenous infections—sources, types, and methods of control, Surg Clin North Am, 48, 227, 10.1016/S0039-6109(16)38448-1

Wiley, 1979, Routes of infection: a study of using “tracer particles” in the orthopedic operating room, Clin Orthop, 139, 150

Slaughter, 1973, Prosthetic valvular endocarditis. A 12-year review, Circulation, 47, 1319, 10.1161/01.CIR.47.6.1319

Carlsson, 1977, Prophylactic antibiotics against early and late deep infections after total hip replacements, Acta Orthop Scand, 48, 405, 10.3109/17453677708992017

Hunter, 1996, Late Clostridium perfringens breast implant infection after dental treatment, Ann Plast Surg, 36, 309, 10.1097/00000637-199603000-00014

Stuesse, 1995, A late sternal wound infection caused by hematogenous spread of bacteria, Chest, 108, 1742, 10.1378/chest.108.6.1742

Howe, 1969, Experimental wound sepsis from transient Escherichia coli bacteremia, Surgery, 66, 570

Velasco, 1996, Risk factors for infectious complications after abdominal surgery for malignant disease, Am J Infect Control, 24, 1, 10.1016/S0196-6553(96)90046-2

Bruun, 1970, Post-operative wound infection. Predisposing factors and the effect of a reduction in the dissemination of staphylococci, Acta Med Scand Suppl, 514, 3

Simchen, 1990, The Israeli Study of Surgical Infection of drains and the risk of wound infection in operations for hernia, Surg Gynecol Obstet, 170, 331

Edwards, 1976, 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, 184, 758, 10.1097/00000658-197612000-00017

Valentine, 1986, Effect of remote infections on clean wound infection rates, Am J Infect Control, 14, 64, 10.1016/0196-6553(86)90057-X

Cioffi, 1988, Total joint replacement: a consideration for antimicrobial prophylaxis, Oral Surg Oral Med Oral Pathol, 66, 124, 10.1016/0030-4220(88)90079-5

Heggeness, 1993, Late infection of spinal instrumentation by hematogenous seeding, Spine, 18, 492, 10.1097/00007632-199318040-00013

Mont, 1997, Multiple irrigation, debridement, and retention of components in infected total knee arthroplasty, J Arthroplasty, 12, 426, 10.1016/S0883-5403(97)90199-6

Ozuna, 1996, Pyogenic vertebral osteomyelitis and postsurgical disc space infections, Ortho Clin North Am, 27, 87, 10.1016/S0030-5898(20)32053-8

Schmalzried, 1992, Etiology of deep sepsis in total hip arthroplasty. The significance of hematogenous and recurrent infections, Clin Orthop, 280, 200, 10.1097/00003086-199207000-00026

Calia, 1969, Importance of the carrier state as a source of Staphylococcus aureus in wound sepsis, J Hyg (Lond), 67, 49, 10.1017/S0022172400041413

Dineen, 1973, Epidemics of postoperative wound infections associated with hair carriers, Lancet, 2, 1157, 10.1016/S0140-6736(73)92933-4

Mastro, 1990, An outbreak of surgical-wound infections due to group A streptococcus carried on the scalp, N Engl J Med, 323, 968, 10.1056/NEJM199010043231406

Ford, 1967, An appraisal of the role of surgical face masks, Am J Surg, 113, 787, 10.1016/0002-9610(67)90348-0

Letts, 1983, Conversation in the operating theater as a cause of airborne bacterial contamination, J Bone Joint Surg [Am], 65, 357, 10.2106/00004623-198365030-00010

Giamarellou, 1996, Epidemiology, diagnosis, and therapy of fungal infections in surgery, Infect Control Hosp Epidemiol, 17, 558, 10.1086/647373

Lee, 1995, Surgical wound infections: surveillance for quality improvement, 145

Perl, 1998, New approaches to reduce Staphylococcus aureus nosocomial infection rates: treating S. aureus nasal carriage, Ann Pharmacother, 32, S7, 10.1177/106002809803200104

Kluytmans, 1995, Nasal carriage of Staphylococcus aureus as a major risk factor for wound infections after cardiac surgery, J Infect Dis, 171, 216, 10.1093/infdis/171.1.216

Perl, 1998, A randomized, double-blind, placebo-controlled clinical trial of intranasal mupirocin ointment (IM) for prevention of S. aureus surgical site infections (SSI), 91

Gil-Egea, 1987, Surgical wound infections: prospective study of 4,486 clean wounds, Infect Control, 8, 277, 10.1017/S0195941700066236

Nagachinta, 1987, Risk factors for surgical-wound infection following cardiac surgery, J Infect Dis, 156, 967, 10.1093/infdis/156.6.967

Lilienfeld, 1988, Obesity and diabetes as risk factors for postoperative wound infections after cardiac surgery, Am J Infect Control, 16, 3, 10.1016/0196-6553(88)90003-X

Slaughter, 1993, A fifteen-year wound surveillance study after coronary artery bypass, Ann Thorac Surg, 56, 1063, 10.1016/0003-4975(95)90014-4

Bryan, 1992, Median sternotomy wound dehiscence: a retrospective case control study of risk factors and outcome, J R Coll Surg Edinb, 37, 305

Jones, 1992, The relationship of cigarette smoking to impaired intraoral wound healing: a review of evidence and implications for patient care, J Oral Maxillofac Surg, 50, 237, 10.1016/0278-2391(92)90318-T

Vinton, 1991, Wound complications after modified radical mastectomy compared with tylectomy with axillary lymph node dissection, Am J Surg, 161, 584, 10.1016/0002-9610(91)90905-S

Holley, 1995, The ramifications of immediate reconstruction in the management of breast cancer, Am Surg, 61, 60

Beitsch, 1992, Operative morbidity and risk factor assessment in melanoma patients undergoing inguinal lymph node dissection, Am J Surg, 164, 462, 10.1016/S0002-9610(05)81181-X

Post, 1991, Risks of intestinal anastomoses in Crohn’s disease, Ann Surg, 213, 37, 10.1097/00000658-199101000-00007

B’erard, 1964, Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and of various other factors, Ann Surg, 160, 1

Nystrom, 1987, Incisional infection after colorectal surgery in obese patients, Acta Chir Scand, 153, 225

He, 1994, Risk factors for operative mortality and sternal wound infection in bilateral internal mammary artery grafting, J Thorac Cardiovasc Surg, 107, 196, 10.1016/S0022-5223(94)70470-8

Barber, 1995, Direct observations of surgical wound infections at a comprehensive cancer center, Arch Surg, 130, 1042, 10.1001/archsurg.1995.01430100020005

Cruse, 1973, A five-year prospective study of 23,649 surgical wounds, Arch Surg, 107, 206, 10.1001/archsurg.1973.01350200078018

Claesson, 1988, Predictors of intraoperative bacterial contamination and postoperative infection in elective colorectal surgery, J Hosp Infect, 11, 127, 10.1016/0195-6701(88)90054-0

Mishriki, 1990, Factors affecting the incidence of postoperative wound infection, J Hosp Infect, 16, 223, 10.1016/0195-6701(90)90110-A

Doig, 1976, Wound infection in a children’s hospital, Br J Surg, 63, 647, 10.1002/bjs.1800630822

Sharma, 1986, Postoperative wound infection in a pediatric surgical service, J Pediatr Surg, 21, 889, 10.1016/S0022-3468(86)80016-1

Casey, 1983, Correlation of immune and nutritional status with wound complications in patients undergoing vascular operations, Surgery, 93, 822

Greene, 1991, Preoperative nutritional status of total joint patients. Relationship to postoperative wound complications, J Arthroplasty, 6, 321, 10.1016/S0883-5403(06)80183-X

Weber, 1995, A prospective analysis of factors influencing outcome after fundoplication, J Pediatr Surg, 30, 1061, 10.1016/0022-3468(95)90342-9

Vamvakas, 1998, Transfusion of white-cell-containing allogeneic blood components and postoperative wound infection: effect of confounding factors, Transfus Med, 8, 29, 10.1046/j.1365-3148.1998.00122.x

Vamvakas, 1996, Blood transfusion and infection after colorectal cancer surgery, Transfusion, 36, 1000, 10.1046/j.1537-2995.1996.36111297091746.x

Jensen, 1996, Randomised comparison of leucocyte-depleted versus buffy-coat-poor blood transfusion and complications after colorectal surgery, Lancet, 348, 841, 10.1016/S0140-6736(96)06168-5

Heiss, 1993, Beneficial effect of autologous blood transfusion on infectious complications after colorectal cancer surgery, Lancet, 342, 1328, 10.1016/0140-6736(93)92247-Q

Lidgren, 1973, Postoperative orthopaedic infections in patients with diabetes mellitus, Acta Orthop Scand, 44, 149, 10.3109/17453677308988678

Gordon, 1997, The relationship between glycosylated hemoglobin (HgA1c) levels and postoperative infections in patients undergoing primary coronary artery bypass surgery (CABG), Infect Control Hosp Epidemiol, 18, 29

Zerr, 1997, Glucose control lowers the risk of wound infection in diabetics after open heart operations, Ann Thorac Surg, 63, 356, 10.1016/S0003-4975(96)01044-2

Terranova, 1991, The effects of diabetes mellitus on wound healing, Plast Surg Nurs, 11, 20, 10.1097/00006527-199121000-00006

Ziv, 1996, Effect of systemic steroids on ileal pouch-anal anastomosis in patients with ulcerative colitis, Dis Colon Rectum, 39, 504, 10.1007/BF02058701

Pons, 1993, Ceftizoxime versus vancomycin and gentamicin in neurosurgical prophylaxis: a randomized, prospective, blinded clinical study, Neurosurgery, 33, 416, 10.1227/00006123-199309000-00010

Brown, 1996, Toward further reducing wound infections in cardiac operations, Ann Thorac Surg, 62, 1783, 10.1016/S0003-4975(96)00566-8

Christou, 1987, Assessing operative site infection in surgical patients, Arch Surg, 122, 165, 10.1001/archsurg.1987.01400140047005

Hu, 1998, Nutritional depletion in staged spinal reconstructive surgery. The effect of total parenteral nutrition, Spine, 23, 1401, 10.1097/00007632-199806150-00019

Schackert, 1986, The predictive role of delayed cutaneous hypersensitivity testing in postoperative complications, Surg Gynecol Obstet, 162, 563

Katelaris, 1986, Prediction of postoperative complications by clinical and nutritional assessment, Aust N Z J Surg, 56, 743, 10.1111/j.1445-2197.1986.tb02319.x

Leite, 1987, Value of nutritional parameters in the prediction of postoperative complications in elective gastrointestinal surgery, Br J Surg, 74, 426, 10.1002/bjs.1800740538

Mullen, 1979, Implications of malnutrition in the surgical patient, Arch Surg, 114, 121, 10.1001/archsurg.1979.01370260011001

Buzby, 1980, Prognostic nutritional index in gastrointestinal surgery, Am J Surg, 139, 160, 10.1016/0002-9610(80)90246-9

Ellis, 1991, Perioperative nutritional support, Surg Clin North Am, 71, 493, 10.1016/S0039-6109(16)45429-0

Haley, 1985, Identifying patients at high risk of surgical wound infection. A simple multivariate index of patient susceptibility and wound contamination, Am J Epidemiol, 121, 206, 10.1093/oxfordjournals.aje.a113991

Culver, 1991, Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System, Am J Med, 91, 152S, 10.1016/0002-9343(91)90361-Z

Windsor, 1988, Weight loss with physiologic impairment. A basic indicator of surgical risk, Ann Surg, 207, 290, 10.1097/00000658-198803000-00011

Campos, 1992, A critical appraisal of the usefulness of perioperative nutritional support, Am J Clin Nutr, 55, 117, 10.1093/ajcn/55.1.117

McPhee, 1998, Factors influencing wound healing after surgery for metastatic disease of the spine, Spine, 23, 726, 10.1097/00007632-199803150-00015

Mullen, 1980, Reduction of operative morbidity and mortality by combined preoperative and postoperative nutritional support, Ann Surg, 192, 604, 10.1097/00000658-198019250-00004

Windsor, 1988, Protein depletion and surgical risk, Aust N Z J Surg, 58, 711, 10.1111/j.1445-2197.1988.tb01101.x

Ulicny, 1990, Sternotomy infection: poor prediction by acute phase response and delayed hypersensitivity, Ann Thorac Surg, 50, 949, 10.1016/0003-4975(90)91128-X

Shukla, 1984, Enteral hyperalimentation in malnourished surgical patients, Indian J Med Res, 80, 339

Moore, 1986, Benefits of immediate jejunostomy feeding after major abdominal trauma—a prospective, randomized study, J Trauma, 26, 874, 10.1097/00005373-198610000-00003

Daly, 1992, Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic, and clinical outcome, Surgery, 112, 56

Daly, 1995, Enteral nutrition during multimodality therapy in upper gastrointestinal cancer patients, Ann Surg, 221, 327, 10.1097/00000658-199504000-00002

Moore, 1992, Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis, Ann Surg, 216, 172, 10.1097/00000658-199208000-00008

Starker, 1983, The response to TPN: a form of nutritional assessment, Ann Surg, 198, 720, 10.1097/00000658-198312000-00010

Muller, 1982, Preoperative parenteral feeding in patients with gastrointestinal carcinoma, Lancet, 1, 68, 10.1016/S0140-6736(82)90212-4

Holter, 1977, The effects of perioperative hyperalimentation on complications in patients with carcinoma and weight loss, J Surg Res, 23, 31, 10.1016/0022-4804(77)90186-X

Thompson, 1981, Perioperative total parenteral nutrition in patients with gastrointestinal cancer, J Surg Res, 30, 497, 10.1016/0022-4804(81)90096-2

Brennan, 1994, A prospective randomized trial of total parenteral nutrition after major pancreatic resection for malignancy, Ann Surg, 220, 436, 10.1097/00000658-199410000-00003

The Veterans Affairs Total Parental Nutrition Cooperative Study Group, 1991, Perioperative total parenteral nutrition in surgical patients, N Engl J Med, 325, 525, 10.1056/NEJM199108223250801

Starker, 1986, The influence of preoperative total parenteral nutrition upon morbidity and mortality, Surg Gynecol Obstet, 162, 569

Senkal, 1997, Early postoperative enteral immunonutrition: clinical outcome and cost-comparison analysis in surgical patients, Crit Care Med, 25, 1489, 10.1097/00003246-199709000-00015

Heatley, 1979, Pre-operative intravenous feeding—a controlled trial, Postgrad Med J, 55, 541, 10.1136/pgmj.55.646.541

Muller, 1986, Indications and effects of preoperative parenteral nutrition, World J Surg, 10, 53, 10.1007/BF01656090

Daly, 1982, Parenteral nutrition in esophageal cancer patients, Ann Surg, 196, 203, 10.1097/00000658-198208000-00014

Klein, 1996, Perioperative nutrition and postoperative complications in patients undergoing spinal surgery, Spine, 21, 2676, 10.1097/00007632-199611150-00018

Garibaldi, 1991, Risk factors for postoperative infection, Am J Med, 91, 158S, 10.1016/0002-9343(91)90362-2

Lee, 1996, Operative complications and quality improvement, Am J Surg, 171, 545, 10.1016/S0002-9610(96)00025-6

Kluytmans, 1996, Reduction of surgical-site infections in cardiothoracic surgery by elimination of nasal carriage of Staphylococcus aureus, Infect Control Hosp Epidemiol, 17, 780, 10.1086/647236

Boyce, 1996, Preventing staphylococcal infections by eradicating nasal carriage of Staphylococcus aureus : proceeding with caution, Infect Control Hosp Epidemiol, 17, 775, 10.1086/647235

Blajchman, 1997, Allogeneic blood transfusions, immunomodulation, and postoperative bacterial infection: do we have the answers yet?, Transfusion, 37, 121, 10.1046/j.1537-2995.1997.37297203512.x

Garibaldi, 1988, Prevention of intraoperative wound contamination with chlorhexidine shower and scrub, J Hosp Infect, 11, 5, 10.1016/0195-6701(88)90149-1

Paulson, 1993, Efficacy evaluation of a 4% chlorhexidine gluconate as a full-body shower wash, Am J Infect Control, 21, 205, 10.1016/0196-6553(93)90033-Z

Hayek, 1987, A placebo-controlled trial of the effect of two preoperative baths or showers with chlorhexidine detergent on postoperative wound infection rates, J Hosp Infect, 10, 165, 10.1016/0195-6701(87)90143-5

Kaiser, 1988, Influence of preoperative showers on staphylococcal skin colonization: a comparative trial of antiseptic skin cleansers, Ann Thorac Surg, 45, 35, 10.1016/S0003-4975(10)62391-0

Rotter, 1988, 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, 11, 310, 10.1016/0195-6701(88)90083-7

Leigh, 1983, Total body bathing with ‘Hibiscrub’ (chlorhexidine) in surgical patients: a controlled trial, J Hosp Infect, 4, 229, 10.1016/0195-6701(83)90023-3

Ayliffe, 1983, A comparison of pre-operative bathing with chlorhexidine-detergent and non-medicated soap in the prevention of wound infection, J Hosp Infect, 4, 237, 10.1016/0195-6701(83)90024-5

Lynch, 1992, Cost-effectiveness analysis of the use of chlorhexidine detergent in preoperative whole-body disinfection in wound infection prophylaxis, J Hosp Infect, 21, 179, 10.1016/0195-6701(92)90074-V

Brady, 1990, Successful control of endemic MRSA in a cardiothoracic surgical unit, Med J Aust, 152, 240, 10.5694/j.1326-5377.1990.tb120917.x

Tuffnell, 1987, Methicillin-resistant Staphylococcus aureus; the role of antisepsis in the control of an outbreak, J Hosp Infect, 10, 255, 10.1016/0195-6701(87)90006-5

Bartzokas, 1984, Control and eradication of methicillin-resistant Staphylococcus aureus on a surgical unit, N Engl J Med, 311, 1422, 10.1056/NEJM198411293112207

Seropian, 1971, Wound infections after preoperative depilatory versus razor preparation, Am J Surg, 121, 251, 10.1016/0002-9610(71)90199-1

Hamilton, 1977, Preoperative hair removal, Can J Surg, 20, 269

Olson, 1986, Preoperative hair removal with clippers does not increase infection rate in clean surgical wounds, Surg Gynecol Obstet, 162, 181

Mehta, 1988, Computer assisted analysis of wound infection in neurosurgery, J Hosp Infect, 11, 244, 10.1016/0195-6701(88)90102-8

Alexander, 1983, The influence of hair-removal methods on wound infections, Arch Surg, 118, 347, 10.1001/archsurg.1983.01390030079013

Masterson, 1984, Bacteriologic evaluation of electric clippers for surgical hair removal, Am J Surg, 148, 301, 10.1016/0002-9610(84)90458-6

Sellick, 1991, Surveillance of surgical wound infections following open heart surgery, Infect Control Hosp Epidemiol, 12, 591, 10.1086/646247

Ko, 1992, Effects of shaving methods and intraoperative irrigation on suppurative mediastinitis after bypass operations, Ann Thorac Surg, 53, 301, 10.1016/0003-4975(92)91337-9

Moro, 1996, Risk factors for surgical wound infections in clean surgery: a multicenter study. Italian PRINOS Study Group, Ann Ital Chir, 67, 13

Winston, 1992, Hair and neurosurgery, Neurosurgery, 31, 320, 10.1227/00006123-199208000-00018

Larson, 1988, Guideline for use of topical antimicrobial agents, Am J Infect Control, 16, 253, 10.1016/S0196-6553(88)80005-1

Hardin, 1997, Handwashing and patient skin preparation, 133

Ritter, 1980, The antimicrobial effectiveness of operative-site preparative agents: a microbiological and clinical study, J Bone Joint Surg Am, 62, 826, 10.2106/00004623-198062050-00020

Mayhall, 1993, Surgical infections including burns, 614

Committee on Control of Surgical Infections of the Committee on Pre- and Postoperative care, 1984

Hardin, 1995, Aseptic technique in the operating room, 109

Lowbury, 1973, Use of 4 percent chlorhexidine detergent solution (Hibiscrub) and other methods of skin disinfection, Br Med J, 1, 510, 10.1136/bmj.1.5852.510

Aly, 1988, Comparative antibacterial efficacy of a 2-minute surgical scrub with chlorhexidine gluconate, povidone-iodine, and chloroxylenol sponge-brushes, Am J Infect Control, 16, 173, 10.1016/0196-6553(88)90029-6

Peterson, 1978, Comparative evaluation of surgical scrub preparations, Surg Gynecol Obstet, 146, 63

Brown, 1984, A clinical evaluation of chlorhexidine gluconate spray as compared with iodophor scrub for preoperative skin preparation, Surg Gynecol Obstet, 158, 363

Lowbury, 1974, The effect of blood on disinfection of surgeons’ hands, Br J Surg, 61, 19, 10.1002/bjs.1800610106

Association of Operating Room Nurses, 1996, Recommended practices for skin preparation of patients, AORN J, 64, 813, 10.1016/S0001-2092(06)63272-9

Kutarski, 1993, 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, 75, 181

Gauthier, 1993, Clean vs sterile surgical skin preparation kits. Cost, safety, effectiveness, AORN J, 58, 486, 10.1016/S0001-2092(07)68436-1

Hagen, 1995, A comparison of two skin preps used in cardiac surgical procedures, AORN J, 62, 393, 10.1016/S0001-2092(06)63580-1

Shirahatti, 1993, Effect of pre-operative skin preparation on post-operative wound infection, J Postgrad Med, 39, 134

Larson, 1990, Alcohol for surgical scrubbing?, Infect Control Hosp Epidemiol, 11, 139, 10.1086/646137

Faoagali, 1995, 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, 23, 337, 10.1016/0196-6553(95)90263-5

Larson, 1995, APIC guideline for handwashing and hand antisepsis in health care settings, Am J Infect Control, 23, 251, 10.1016/0196-6553(95)90070-5

Rubio, 1987, Septisol antiseptic foam: a sensible alternative to the conventional surgical scrub, Int Surg, 72, 243

Lowbury, 1974, Preoperative disinfection of surgeons’ hands: use of alcoholic solutions and effects of gloves on skin flora, Br Med J, 4, 369, 10.1136/bmj.4.5941.369

Rotter, 1984, Hygienic hand disinfection, Infect Control, 5, 18, 10.1017/S0195941700058744

Ayliffe, 1984, Surgical scrub and skin disinfection, Infect Control, 5, 23, 10.1017/S0195941700058756

Lilly, 1979, Delayed antimicrobial effects of skin disinfection by alcohol, J Hyg (Lond), 82, 497, 10.1017/S0022172400054024

Nichols, 1997, Current practices of preoperative bowel preparation among North American colorectal surgeons, Clin Infect Dis, 24, 609, 10.1093/clind/24.4.609

Wade, 1991, The evaluation of residual antimicrobial activity on hands and its clinical relevance, J Hosp Infect, 18, 23, 10.1016/0195-6701(91)90259-B

Babb, 1991, A test procedure for evaluating surgical hand disinfection, J Hosp Infect, 18, 41, 10.1016/0195-6701(91)90262-7

Holloway, 1990, A multi-centre evaluation of two chlorhexidine-containing formulations for surgical hand disinfection, J Hosp Infect, 16, 151, 10.1016/0195-6701(90)90059-W

Kobayashi, 1991, Evaluation of surgical scrubbing, J Hosp Infect, 18, 29, 10.1016/0195-6701(91)90260-F

Nicoletti, 1990, Hygienic hand disinfection: a comparative study with chlorhexidine detergents and soap, J Hosp Infect, 15, 323, 10.1016/0195-6701(90)90089-7

Rotter, 1990, Surgical hand disinfection: effect of sequential use of two chlorhexidine preparations, J Hosp Infect, 16, 161, 10.1016/0195-6701(90)90060-2

O’Shaughnessy, 1991, Optimum duration of surgical scrub-time, Br J Surg, 78, 685, 10.1002/bjs.1800780617

Hingst, 1992, Evaluation of the efficacy of surgical hand disinfection following a reduced application time of 3 instead of 5 min, J Hosp Infect, 20, 79, 10.1016/0195-6701(92)90109-Y

Wheelock, 1997, Effect of surgical hand scrub time on subsequent bacterial growth, AORN J, 65, 1087, 10.1016/S0001-2092(06)62949-9

Deshmukh, 1998, A comparison of 5-minute povidone-iodine scrub and 1-minute povidone-iodine scrub followed by alcohol foam, Mil Med, 163, 145, 10.1093/milmed/163.3.145

Masterson, 1996, Cleansing the surgeon’s hands, Scientific American Surgeon, 2, 3

Association of Operating Room Nurses, 1999

Pottinger, 1989, Bacterial carriage by artificial versus natural nails, Am J Infect Control, 17, 340, 10.1016/0196-6553(89)90003-5

Passaro, 1997, Postoperative Serratia marcescens wound infections traced to an out-of-hospital source, J Infect Dis, 175, 992, 10.1086/514008

Baumgardner, 1993, Effects of nail polish on microbial growth of fingernails. Dispelling sacred cows, AORN J, 58, 84, 10.1016/S0001-2092(07)65103-5

Jacobson, 1985, Handwashing: ring-wearing and number of microorganisms, Nurs Res, 34, 186, 10.1097/00006199-198505000-00012

Hoffman, 1985, Micro-organisms isolated from skin under wedding rings worn by hospital staff, Br Med J (Clin Res Ed), 290, 206, 10.1136/bmj.290.6463.206

Richet, 1991, Analysis of risk factors for surgical wound infections following vascular surgery, Am J Med, 91, 170S, 10.1016/0002-9343(91)90364-4

Centers for Disease Control, 1990, Epidemic keratoconjunctivitis in an ophthalmology clinic—California, MMWR, 39, 598

Ford, 1987, Epidemiology of epidemic keratoconjunctivitis, Epidemiol Rev, 9, 244, 10.1093/oxfordjournals.epirev.a036304

Birenbaum, 1993, Adenovirus type 8 conjunctivitis outbreak in a neonatal intensive care unit, Arch Dis Child, 68, 610, 10.1136/adc.68.5_Spec_No.610

Warren, 1989, A large outbreak of epidemic keratoconjunctivitis: problems in controlling nosocomial spread, J Infect Dis, 160, 938, 10.1093/infdis/160.6.938

Jernigan, 1993, Adenovirus type 8 epidemic keratoconjunctivitis in an eye clinic: risk factors and control, J Infect Dis, 167, 1307, 10.1093/infdis/167.6.1307

Boyce, 1991, Should we vigorously try to contain and control methicillin-resistant Staphylococcus aureus?, Infect Control Hosp Epidemiol, 12, 46, 10.1086/646237

Boyce, 1993, Spread of methicillin-resistant Staphylococcus aureus in a hospital after exposure to a health care worker with chronic sinusitis, Clin Infect Dis, 17, 496, 10.1093/clinids/17.3.496

Sheretz, 1996, A cloud adult: the Staphylococcus aureus-virus interaction revisited, Ann Intern Med, 124, 539, 10.7326/0003-4819-124-6-199603150-00001

Belani, 1986, Outbreak of staphylococcal infection in two hospital nurseries traced to a single nasal carrier, Infect Control, 7, 487, 10.1017/S0195941700065097

Kreiswirth, 1986, Nosocomial transmission of a strain of Staphylococcus aureus causing toxic shock syndrome, Ann Intern Med, 105, 704, 10.7326/0003-4819-105-5-704

Weber, 1996, Management of healthcare workers with pharyngitis or suspected streptococcal infections, Infect Control Hosp Epidemiol, 17, 753, 10.1086/647223

Viglionese, 1991, Recurrent group A streptococcal carriage in a health care worker associated with widely separated nosocomial outbreaks, Am J Med, 91, 329S, 10.1016/0002-9343(91)90391-A

Paul, 1990, Postoperative group A beta-hemolytic streptococcus outbreak with the pathogen traced to a member of a healthcare worker’s household, Infect Control Hosp Epidemiol, 11, 643, 10.1086/646115

Ridgway, 1993, Clustering of group A streptococcal infections on a burns unit: important lessons in outbreak management, J Hosp Infect, 25, 173, 10.1016/0195-6701(93)90035-X

Berkelman, 1982, Streptococcal wound infection caused by a vaginal carrier, JAMA, 247, 2680, 10.1001/jama.247.19.2680

Schaffner, 1969, Hospital outbreak of infections with group A streptococci traced to an asymptomatic anal carrier, N Engl J Med, 280, 1224, 10.1056/NEJM196905292802209

Richman, 1977, Scarlet fever and group A streptococcal surgical wound infection traced to an anal carrier, J Pediatr, 90, 387, 10.1016/S0022-3476(77)80698-7

Stromberg, 1988, Throat carrier rates of beta-hemolytic streptococci among healthy adults and children, Scand J Infect Dis, 20, 411, 10.3109/00365548809032477

Stamm, 1978, Wound infection due to group A streptococcus traced to a vaginal carrier, J Infect Dis, 138, 287, 10.1093/infdis/138.3.287

Bolyard, 1998, Guideline for infection control in healthcare personnel, 1998. Hospital Infection Control Practices Advisory Committee, Am J Infect Control, 26, 289, 10.1016/S0196-6553(98)80015-1

Nichols, 1995, Prophylaxis in bowel surgery, Curr Clin Top Infect Dis, 15, 76

Nichols, 1994, Preventive antibiotic usage in traumatic thoracic injuries requiring closed tube thoracostomy, Chest, 106, 1493, 10.1378/chest.106.5.1493

Bullock, 1988, A double-blind placebocontrolled trial of perioperative prophylactic antibiotics for elective neurosurgery, J Neurosurg, 69, 687, 10.3171/jns.1988.69.5.0687

Page, 1993, Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care, Arch Surg, 128, 79, 10.1001/archsurg.1993.01420130087014

McQueen, 1987, A comparison of systemic cefuroxime and cefuroxime loaded bone cement in the prevention of early infection after total joint replacement, Int Orthop, 11, 241, 10.1007/BF00271455

Henley, 1986, Prophylaxis with cefamandole nafate in elective orthopedic surgery, Clin Orthop, 209, 249, 10.1097/00003086-198608000-00038

Buckley, 1990, Perioperative cefazolin prophylaxis in hip fracture surgery, Can J Surg, 33, 122

Boyd, 1973, A double-blind clinical trial of prophylactic antibiotic in hip fractures, J Bone Joint Surg [Am], 55A, 1251, 10.2106/00004623-197355060-00012

Bernard, 1994, Antibiotic prophylaxis in pulmonary surgery. A prospective randomized double-blind trial of flash cefuroxime versus forty-eight-hour cefuroxime, J Thorac Cardiovasc Surg, 107, 896, 10.1016/S0022-5223(94)70347-7

Platt, 1993, Perioperative antibiotic prophylaxis and wound infection following breast surgery, J Antimicrob Chemother, 31, 43, 10.1093/jac/31.suppl_B.43

Rimoldi, 1996, The use of antibiotics for wound prophylaxis in spinal surgery, Orthop Clin North Am, 27, 47, 10.1016/S0030-5898(20)32049-6

Bennion, 1985, A randomized, prospective study of perioperative antimicrobial prophylaxis for vascular access surgery, J Cardiovasc Surg (Torino), 26, 270

Kaiser, 1987, 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, 206, 791, 10.1097/00000658-198712000-00018

Miedzinski, 1990, Antimicrobial prophylaxis for open heart operations, Ann Thorac Surg, 50, 800, 10.1016/0003-4975(90)90690-8

Doebbeling, 1990, Cardiovascular surgery prophylaxis. A randomized, controlled comparison of cefazolin and cefuroxime, J Thorac Cardiovasc Surg, 99, 981, 10.1016/S0022-5223(20)31454-9

Madsen, 1996, Penicillin prophylaxis in complicated wounds of hands and feet: a randomized , double-blind trial, Injury, 27, 275, 10.1016/0020-1383(95)00224-3

Burnett, 1980, Prophylactic antibiotics in hip fractures. A double-bind, prospective study, J Bone Joint Surg [Am], 62, 457, 10.2106/00004623-198062030-00017

Nichols, 1982, Efficacy of antibiotic prophylaxis in high risk gastroduodenal operations, Am J Surg, 143, 94, 10.1016/0002-9610(82)90136-2

Lewis, 1991, Efficacy and distribution of single-dose preoperative antibiotic prophylaxis in high-risk gastroduodenal surgery, Can J Surg, 34, 117

Young, 1987, Perioperative antibiotic prophylaxis for prevention of postoperative neurosurgical infections. A randomized clinical trial, J Neurosurg, 66, 701, 10.3171/jns.1987.66.5.0701

Djindjian, 1990, Antibiotic prophylaxis during prolonged clean neurosurgery. Results of a randomized double-blind study using oxacillin, J Neurosurg, 73, 383, 10.3171/jns.1990.73.3.0383

Targarona, 1990, Single-dose antibiotic prophylaxis in patients at high risk for infection in biliary surgery: a prospective and randomized study comparing cefonicid with mezlocillin, Surgery, 107, 327

van Ek, 1988, Antibiotic prophylaxis in craniotomy: a prospective double-blind placebo-controlled study, Scand J Infect Dis, 20, 633, 10.3109/00365548809035664

Krige, 1992, Prospective, randomized study comparing amoxycillin-clavulanic acid and cefamandole for the prevention of wound infection in high-risk patients undergoing elective biliary surgery, J Hosp Infect, 22, 33, 10.1016/S0195-6701(05)80005-2

Browder, 1989, Nonperforative appendicitis: a continuing surgical dilemma, J Infect Dis, 159, 1088, 10.1093/infdis/159.6.1088

Platt, 1997, Guidelines for perioperative antibiotic prophylaxis, 229

Sanderson, 1993, Antimicrobial prophylaxis in surgery: microbiological factors, J Antimicrob Chemother, 31, 1, 10.1093/jac/31.suppl_B.1

Anonymous, 1997, Med Lett Drugs Ther, 39, 97

Scher, 1997, Studies on the duration of antibiotic administration for surgical prophylaxis, Am Surg, 63, 59

Nichols, 1989, Antibiotic prophylaxis in surgery, J Chemother, 1, 170, 10.1080/1120009X.1989.11738887

Ehrenkranz, 1993, Antimicrobial prophylaxis in surgery: mechanisms, misconceptions, and mischief, Infect Control Hosp Epidemiol, 14, 99, 10.1086/646690

Berkeley, 1988, Comparison of cefotetan and cefoxitin prophylaxis for abdominal and vaginal hysterectomy, Am J Obstet Gynecol, 158, 706, 10.1016/S0002-9378(16)44531-X

Ehrenkranz, 1990, Infections complicating low-risk cesarean sections in community hospitals: efficacy of antimicrobial prophylaxis, Am J Obstet Gynecol, 162, 337, 10.1016/0002-9378(90)90381-G

Soper, 1993, Infections following cesarean section, Curr Opin Obstet Gynecol, 5, 517, 10.1097/00001703-199308000-00016

Enkin, 1989, Prophylactic antibiotics in association with caesarean section, 1246

Allen, 1972, Use of a prophylactic antibiotic in elective major gynecologic operations, Obstet Gynecol, 39, 218

The Multicenter Study Group, 1989, Single dose prophylaxis in patients undergoing vaginal hysterectomy: cefamandole versus cefotaxime, Am J Obstet Gynecol, 160, 1198, 10.1016/0002-9378(89)90189-0

Roy, 1989, Comparative efficacy and safety of cefmetazole or cefoxitin in the prevention of postoperative infection following vaginal and abdominal hysterectomy, J Antimicrob Chemother, 23, 109, 10.1093/jac/23.suppl_D.109

Friese, 1989, 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, 24, 213, 10.1093/jac/24.suppl_B.213

Senior, 1986, Are preoperative antibiotics helpful in abdominal hysterectomy?, Am J Obstet Gynecol, 154, 1004, 10.1016/0002-9378(86)90738-6

Hemsell, 1988, Single dose antimicrobial prophylaxis at abdominal hysterectomy. Cefamandole vs. cefotaxime, J Reprod Med, 33, 939

Hemsell, 1985, Preoperative cefoxitin prophylaxis for elective abdominal hysterectomy, Am J Obstet Gynecol, 153, 225, 10.1016/0002-9378(85)90120-6

DiPiro, 1986, Single dose systemic antibiotic prophylaxis of surgical wound infections, Am J Surg, 152, 552, 10.1016/0002-9610(86)90228-X

Trilla, 1993, Perioperative antibiotic prophylaxis, 665

Ehrenkranz, 1992, Surgical infections, 685

Nichols, 1995, Surgical antibiotic prophylaxis, Med Clin North Am, 79, 509, 10.1016/S0025-7125(16)30053-0

Classen, 1992, The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection, N Engl J Med, 326, 281, 10.1056/NEJM199201303260501

McDonald, 1998, Single- versus multiple-dose antimicrobial prophylaxis for major surgery: a systematic review, Aust N Z J Surg, 68, 388, 10.1111/j.1445-2197.1998.tb04785.x

Clarke, 1977, Preoperative oral antibiotics reduce septic complications of colon operations: results of prospective, randomized, double-blind clinical study, Ann Surg, 186, 251, 10.1097/00000658-197709000-00003

Condon, 1983, Efficacy of oral and systemic antibiotic prophylaxis in colorectal operations, Arch Surg, 118, 496, 10.1001/archsurg.1983.01390040100021

Bartlett, 1978, 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, 188, 249, 10.1097/00000658-197808000-00020

Da Costa, 1998, Antibiotic prophylaxis for permanent pacemaker implantation: a meta-analysis, Circulation, 97, 1796, 10.1161/01.CIR.97.18.1796

Bumpous, 1995, The infected wound and its management, Otolaryngol Clin North Am, 28, 987, 10.1016/S0030-6665(20)30471-0

Hospital Infection Control Practices Advisory Committee, 1995, Recommendations for preventing the spread of vancomycin resistance, Infect Control Hosp Epidemiol, 16, 105, 10.1086/647066

Forse, 1989, Antibiotic prophylaxis for surgery in morbidly obese patients, Surgery, 106, 750

Polk, 1995, Systemic antibiotic prophylaxis in surgery, 127

Ayliffe, 1991, Role of the environment of the operating suite in surgical wound infection, Rev Infect Dis, 13, S800, 10.1093/clinids/13.Supplement_10.S800

Gryska, 1970, Postoperative streptococcal wound infection. The anatomy of an epidemic, JAMA, 213, 1189, 10.1001/jama.213.7.1189

McIntyre, 1968, An epidemic of Streptococcus pyogenes puerperal and postoperative sepsis with an unusual carrier site—the anus, Am J Obstet Gynecol, 101, 308, 10.1016/0002-9378(68)90056-2

Lidwell, 1986, Clean air at operation and subsequent sepsis in the joint, Clin Orthop, 211, 91, 10.1097/00003086-198610000-00013

American Institute of Architects, 1996

Nichols, 1992, The operating room, 461

Laufman, 1986, The operating room, 315

Sessler, 1992, Thermoregulatory vasoconstriction during isoflurane anesthesia minimally decreases cutaneous heat loss, Anesthesiology, 76, 670, 10.1097/00000542-199205000-00002

Hambraeus, 1988, Aerobiology in the operating room—a review, J Hosp Infect, 11, 68, 10.1016/0195-6701(88)90169-7

Babb, 1995, Risk of airborne transmission in an operating theatre containing four ultraclean air units, J Hosp Infect, 31, 159, 10.1016/0195-6701(95)90062-4

Charnley, 1972

Friberg, 1998, Ultraclean laminar airflow ORs, AORN J, 67, 841, 10.1016/S0001-2092(06)62647-1

Lidwell, 1987, Ultraclean air and antibiotics for prevention of postoperative infection. A multicenter study of 8,052 joint replacemnet operations, Acta Orthop Scand, 58, 4, 10.3109/17453678709146334

Nelson, 1976, The operating room environment and its influence on deep wound infection, J Bone Joint Surg, 1

Whyte, 1993, Infection control in hospital operating rooms, Cleanrooms 1993 Proceedings, 157

Charnley, 1964, A clean-air operating enclosure, Br J Surg, 51, 202, 10.1002/bjs.1800510309

Lidwell, 1982, 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, 285, 10, 10.1136/bmj.285.6334.10

Taylor, 1995, Wound disinfection with ultraviolet radiation, J Hosp Infect, 30, 85, 10.1016/0195-6701(95)90148-5

Bueno Cavanillas, 1991, Preoperative stay as a risk factor for nosocomial infection, Eur J Epidemiol, 7, 670, 10.1007/BF00218680

Favero, 1991, Sterilization, disinfection, and antisepsis in the hospital, 183

U.S. Department of Labor, Occupational Safety and Health Administration, 1991, Occupational exposure to bloodborne pathogens; final rule (29 CFR Part 1910.1030), Federal Register, 56, 64004

Rudnick, 1996, Gram-negative bacteremia in open-heart-surgery patients traced to probable tap-water contamination of pressure-monitoring equipment, Infect Control Hosp Epidemiol, 17, 281, 10.1086/647296

Centers for Disease Control, 1992, Postsurgical infections associated with nonsterile implantable devices, MMWR Morb Mortal Wkly Rep, 41, 263

Soto, 1991, Post-surgical nasal cellulitis outbreak due to Mycobacterium chelonae, J Hosp Infect, 19, 99, 10.1016/0195-6701(91)90102-E

Favero, 1993, Is eliminating flash sterilization practical?, Infect Control Hosp Epidemiol, 14, 479, 10.1086/646784

American Society for Healthcare Central Service Personnel, 1993

Association for the Advancement of Medical Instrumentation, 1996

Rutala, 1993, Evaluation of a rapid readout biological indicator for flash sterilization with three biological indicators and three chemical indicators, Infect Control Hosp Epidemiol, 14, 390, 10.1086/646767

Vesley, 1992, Fluorimetric detection of a Bacillus stearothermophilus spore-bound enzyme, alpha-D-glucosidase, for rapid indication of flash sterilization failure, Appl Environ Microbiol, 58, 717, 10.1128/AEM.58.2.717-719.1992

Rutala, 1996, Comparison of a rapid readout biological indicator for steam sterilization with four conventional biological indicators and five chemical indicators, Infect Control Hosp Epidemiol, 17, 423, 10.1086/647333

Vesley, 1995, 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, 16, 281, 10.1086/647108

Smith, 1980, What is the purpose of the scrub suit?, AORN J, 31, 769, 10.1016/S0001-2092(07)61447-1

Dineen, 1973, The role of impervious drapes and gowns preventing surgical infection, Clin Orthop, 96, 210, 10.1097/00003086-197310000-00030

Ha’eri, 1980, The efficacy of standard surgical face masks: an investigation using “tracer particles”, Clin Orthop, 148, 160

Moylan, 1987, Reducing wound infections. Improved gown and drape barrier performance, Arch Surg, 122, 152, 10.1001/archsurg.1987.01400140034003

Moylan, 1974, Intraoperative bacterial transmission, Surg Forum, 25, 29

Copp, 1986, Covergowns and the control of operating room contamination, Nurs Res, 35, 263, 10.1097/00006199-198609000-00003

Beck, 1992, The surgical mask: another ‘sacred cow’?, AORN J, 55, 955, 10.1016/S0001-2092(07)70339-3

Mitchell, 1991, Surgical face masks in modern operating rooms—a costly and unnecessary ritual?, J Hosp Infect, 18, 239, 10.1016/0195-6701(91)90148-2

Tunevall, 1992, Influence of wearing masks on the density of airborne bacteria in the vicinity of the surgical wound, Eur J Surg, 158, 263

Tunevall, 1991, Postoperative wound infections and surgical face masks: a controlled study, World J Surg, 15, 383, 10.1007/BF01658736

Orr, 1981, Is a mask necessary in the operating theatre?, Ann R Coll Surg Engl, 63, 390

Lee, 1997, Making surgical care better: hard work, small gains, Infect Control Hosp Epidemiol, 18, 6, 10.1086/647493

Jarvis, 1995, Respirators, recommendations, and regulations: the controversy surrounding protection of health care workers from tuberculosis, Ann Intern Med, 122, 142, 10.7326/0003-4819-122-2-199501150-00011

Centers for Disease Control and Prevention, 1995

Humphreys, 1991, Theatre over-shoes do not reduce operating theatre floor bacterial counts, J Hosp Infect, 17, 117, 10.1016/0195-6701(91)90175-8

Weightman, 1994, Protective over-shoes are unnecessary in a day surgery unit, J Hosp Infect, 28, 1, 10.1016/0195-6701(94)90147-3

Whyte, 1991, The relative importance of routes and sources of wound contamination during general surgery. I. Non-airborne, J Hosp Infect, 18, 93, 10.1016/0195-6701(91)90154-Z

Dodds, 1988, Surgical glove perforation, Br J Surg, 75, 966, 10.1002/bjs.1800751009

Tokars, 1995, Skin and mucous membrane contacts with blood during surgical procedures: risk and prevention, Infect Control Hosp Epidemiol, 16, 703, 10.1086/647044

Short, 1993, Risk of occupational infection with blood-borne pathogens in operating and delivery room settings, Am J Infect Control, 21, 343, 10.1016/0196-6553(93)90400-X

Garibaldi, 1986, Comparison of nonwoven and woven gown and drape fabric to prevent intraoperative wound contamination and postoperative infection, Am J Surg, 152, 505, 10.1016/0002-9610(86)90216-3

Muller, 1989, The use of disposable draping materials in the operating room and its effect on the postoperative wound infection rate, Wein Klin Wochenschr, 101, 837

Smith, 1991, Barrier efficiency of surgical gowns. Are we really protected from our patients’ pathogens?, Arch Surg, 126, 756, 10.1001/archsurg.1991.01410300102016

Artz, 1960, Protection of the surgical wound with a new plastic film, JAMA, 174, 1865, 10.1001/jama.1960.63030140013024c

Chiu, 1993, Plastic adhesive drapes and wound infection after hip fracture surgery, Aust N Z J Surg, 63, 798, 10.1111/j.1445-2197.1993.tb00343.x

American Society for Testing Materials, 1998

American Society for Testing Materials, 1997

McCullough, 1993, Methods for determining the barrier efficacy of surgical gowns, Am J Infect Control, 21, 368, 10.1016/0196-6553(93)90404-R

Lewis, 1998, Breaking the comfort barrier in impervious gowns, Surgical Services Management, 4, 29

Granzow, 1998, Evaluation of the protective value of hospital gowns against blood strike-through and methicillin-resistant Staphylococcus aureus penetration, Am J Infect Control, 26, 85, 10.1016/S0196-6553(98)80027-8

Walter, 1966, The infector on the surgical team, Clin Neurosurg, 14, 361, 10.1093/neurosurgery/14.CN_suppl_1.361

Payne, 1967, Severe outbreak of surgical sepsis due to Staphylococcus aureus of unusual type and origin, Br Med J, 4, 17, 10.1136/bmj.4.5570.17

Centers for Disease Control, 1976, Hospital outbreak of streptococcal wound infection-Utah, MMWR Morb Mortal Wkly Rep, 25, 141

Herwaldt, 1996, Nosocomial infections associated with anesthesia, 655

Bennett, 1995, Postoperative infections traced to contamination of an intravenous anesthetic, propofol, N Engl J Med, 333, 147, 10.1056/NEJM199507203330303

Froggatt, 1991, Hospital outbreak of hepatitis B in patients undergoing electroconvulsive therapy [abstract]., 157

Centers for Disease Control, 1990, Postsurgical infections associated with an extrinsically contaminated intravenous anesthetic agent—California, Illinois, Maine, and Michigan, 1990, MMWR Morb Mortal Wkly Rep, 39, 426

Daily, 1991, Endogenous Candida endophthalmitis after intravenous anesthsia with propofol, Arch Ophthalmol, 109, 1081, 10.1001/archopht.1991.01080080041024

Villarino, 1991, Postsurgical infections associated with an extrinsically contaminated intravenous anesthetic agent [abstract], 156

American Association of Nurse Anesthetists, 1993

American Society of Anesthesiologists, 1992

Garner, 1986, CDC guideline for handwashing and hospital environmental control, 1985, Infect Control, 7, 231, 10.1017/S0195941700084022

Zacharias, 1996, Delayed primary closure of deep sternal wound infections, Tex Heart Inst J, 23, 211

Smilanich, 1995, Contaminated wounds: the effect of initial management on outcome, Am Surg, 61, 427

Blomstedt, 1985, Infections in neurosurgery: a randomized comparison between silk and polyglycolic acid, Acta Neurochir (Wien), 76, 90, 10.1007/BF01418466

Scher, 1985, Infectivity of vascular sutures, Am Surg, 51, 577

Durdey, 1984, Assessment of sutures for use in colonic surgery: an experimental study, J R Soc Med, 77, 472, 10.1177/014107688407700606

Chu, 1984, Effects of physical configuration and chemical structure of suture materials on bacterial adhesion. A possible link to wound infection, Am J Surg, 147, 197, 10.1016/0002-9610(84)90088-6

Askew, 1983, A comparison of upper abdominal wound closure with monofilament nylon and polyglycolic acid, Aust N Z J Surg, 53, 353, 10.1111/j.1445-2197.1983.tb02462.x

Kapadia, 1983, Behaviour of synthetic absorbable sutures with and without synergistic enteric infection, Eur Surg Res, 15, 67, 10.1159/000128335

Bucknall, 1983, The choice of a suture to close abdominal incisions, Eur Surg Res, 15, 59, 10.1159/000128334

Bucknall, 1983, Factors influencing wound compications: a clinical and experimental study, Ann R Coll Surg Engl, 65, 71

Varma, 1981, Further studies with polyglycolic acid (Dexon) and other sutures in infected experimental wounds, Am J Vet Res, 42, 571

Bucknall, 1981, Abdominal wound closure—a comparison of monofilament nylon and polyglycolic acid, Surgery, 89, 672

Dougherty, 1992, The biology and practice of surgical drains. Part II, Curr Probl Surg, 29, 635, 10.1016/0011-3840(92)90028-2

Cruse, 1988, Wound infections: epidemiology and clinical characteristics in surgical infectious disease, 319

Drinkwater, 1995, Optimal timing of wound drain removal following total joint arthroplasty, J Arthroplasty, 10, 185, 10.1016/S0883-5403(05)80125-1

Tollofsrud, 1984, Perioperative hypothermia, Acta Anaesthesiol Scand, 28, 511, 10.1111/j.1399-6576.1984.tb02109.x

Sessler, 1997, Mild perioperative hypothermia, N Engl J Med, 336, 1730, 10.1056/NEJM199706123362407

Kurz, 1996, Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group, N Engl J Med, 334, 1209, 10.1056/NEJM199605093341901

Hunt, 1997, Wound healing and wound infection. What surgeons and anesthesiologists can do, Surg Clin North Am, 77, 587, 10.1016/S0039-6109(05)70570-3

Wenisch, 1996, Mild intraoperative hypothermia reduces production of reactive oxygen intermediates by polymorphonuclear leukocytes, Anesth Analg, 82, 810

Jonsson, 1988, Oxygen as an isolated variable influences resistance to infection, Ann Surg, 208, 783, 10.1097/00000658-198812000-00018

Jonsson, 1987, Assessment of perfusion in postoperative patients using tissue oxygen measurements, Br J Surg, 74, 263, 10.1002/bjs.1800740413

Chang, 1983, Direct measurement of wound and tissue oxygen tension in postoperative patients, Ann Surg, 197, 470, 10.1097/00000658-198304000-00017

Knighton, 1984, Oxygen as an antibiotic. The effect of inspired oxygen on infection, Arch Surg, 119, 199, 10.1001/archsurg.1984.01390140057010

Ikeda, 1998, Local radiant heating increases subcutaneous oxygen tension, Am J Surg, 175, 33, 10.1016/S0002-9610(97)00237-7

DuMortier, 1933, The resistance of healing wounds to infection, Surg Gynecol Obstet, 56, 762

Morain, 1990, Wound healing in diabetes mellitus, Clin Plast Surg, 17, 493, 10.1016/S0094-1298(20)30624-6

American Hospital Association, 1979, Infection control in the hospital, 161

Castle, 1987, Hospital infection control: principles and practice, 114

Centers for Disease Control, 1970

Kravitz, 1996, Outpatient wound care, Crit Care Nurs Clin North Am, 8, 217, 10.1016/S0899-5885(18)30337-X

Condon, 1983, Effectiveness of a surgical wound surveillance program, Arch Surg, 118, 303, 10.1001/archsurg.1983.01390030035006

Haley, 1985, The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals, Am J Epidemiol, 121, 182, 10.1093/oxfordjournals.aje.a113990

Lennard, 1985, Postoperative wound infection surveillance by use of bacterial contamination categories, Am J Infect Control, 13, 147, 10.1016/0196-6553(85)90101-4

Olson, 1990, Continuous, 10-year wound infection surveillance. Results, advantages, and unanswered questions, Arch Surg, 125, 794, 10.1001/archsurg.1990.01410180120020

Olson, 1984, Surgical wound infections. A 5-year prospective study of 20,193 wounds at the Minneapolis VA Medical Center, Ann Surg, 199, 253, 10.1097/00000658-198403000-00001

Weigelt, 1985, Risk of wound infections in trauma patients, Am J Surg, 150, 782, 10.1016/0002-9610(85)90429-5

Weigelt, 1987, Factors which influence the risk of wound infection in trauma patients, J Trauma, 27, 774, 10.1097/00005373-198707000-00015

Anonymous, 1963, New classification of physical status, Anesthesiology, 24, 111

Owens, 1978, ASA physical status classification: a study on consistency of ratings, Anesthesiology, 49, 239, 10.1097/00000542-197810000-00003

National Nosocomial Infections Surveillance System, 1991, Nosocomial infection rates for interhospital comparison: limitations and possible solutions. A report from the National Nosocomial Infections Surveillance (NNIS) System, Infect Control Hosp Epidemiol, 12, 609, 10.1086/646250

Cardo, 1993, Validation of surgical wound surveillance, Infect Control Hosp Epidemiol, 14, 211, 10.1086/646717

Horan, 1994, Development of predictive risk factors for nosocomial surgical site infections (SSI), Infect Control Hosp Epidemiol, 15, 46(M72

Nichols, 1984, Risk of infection after penetrating abdominal trauma, N Engl J Med, 311, 1065, 10.1056/NEJM198410253111701

Nichols, 1993, Prospective alterations in therapy for penetrating abdominal trauma, Arch Surg, 128, 55, 10.1001/archsurg.1993.01420130059010

Horan, 1996, Results of a multicenter study on risk factors for surgical site infections (SSI) following C-section (CSEC), Am J Infect Control, 24, 84

Roy, 1994

Lee, 1997, Surveillance in acute care and nonacute care settings: current issues and concepts, Am J Infect Control, 25, 121, 10.1016/S0196-6553(97)90039-0

Lee, 1992, Wound infection surveillance, Infect Dis Clin North Am, 6, 643, 10.1016/S0891-5520(20)30467-0

Mead, 1986, Decreasing the incidence of surgical wound infections. Validation of a surveillance-notification program, Arch Surg, 121, 458, 10.1001/archsurg.1986.01400040096015

Kerstein, 1978, Surveillance for postoperative wound infections: practical aspects, Am Surg, 44, 210

Poulsen, 1995, Failure to detect a general reduction of surgical wound infections in Danish hospitals, Dan Med Bull, 42, 485

Haley, 1980, The accuracy of retrospective chart review in measuring nosocomial infection rates. Results of validation studies in pilot hospitals, Am J Epidemiol, 111, 516, 10.1093/oxfordjournals.aje.a112931

Mulholland, 1974, Analysis and significance of nosocomial infection rates, Ann Surg, 180, 827, 10.1097/00000658-197412000-00005

Wenzel, 1976, Hospital-acquired infections. I. Surveillance in a university hospital, Am J Epidemiol, 103, 251, 10.1093/oxfordjournals.aje.a112223

Simchen, 1981, Multivariate analysis of determinants of postoperative wound infection: a possible basis for intervention, Rev Infect Dis, 3, 678, 10.1093/clinids/3.4.678

Collier, 1987, Community hospital surgeon-specific infection rates, Infect Control, 8, 249, 10.1017/S0195941700066133

Ehrenkranz, 1995, 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, 16, 697, 10.1086/647043

Hirschhorn, 1993, Electronic surveillance of antibiotic exposure and coded discharge diagnoses as indicators of postoperative infection and other quality assurance measures, Infect Control Hosp Epidemiol, 14, 21, 10.1086/646626

Simchen, 1988, 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, 9, 232, 10.1086/645845

Burns, 1982, Postoperative wound infections detected during hospitalization and after discharge in a community hospital, Am J Infect Control, 10, 60, 10.1016/0196-6553(82)90004-9

Laxson, 1984, Surveillance for the detection of nosocomial infections and the potential for nosocomial outbreaks, Am J Infect Control, 12, 318, 10.1016/0196-6553(84)90003-8

Mertens, 1994, A computerized nationwide network for nosocomial infection surveillance in Belgium, Infect Control Hosp Epidemiol, 15, 171, 10.1086/646885

Ehrenkranz, 1981, Surgical wound infection occurrence in clean operations; risk stratification for interhospital comparisons, Am J Med, 909, 10.1016/0002-9343(81)90554-4

Baker, 1995, Comparison of case-finding methodologies for endometritis after cesarean section, Am J Infect Control, 23, 27, 10.1016/0196-6553(95)90005-5

Gaynes, 1996, Surveillance of nosocomial infections, 1017

Horan, 1997, Definitions of key terms used in the NNIS system, Am J Infect Control, 25, 112, 10.1016/S0196-6553(97)90037-7

Polk, 1980, Randomised clinical trial of perioperative cefazolin in preventing infection after hysterectomy, Lancet, 1, 437, 10.1016/S0140-6736(80)90994-0

Salem, 1979, Short term metronidazole therapy contrasted with povidone-iodine spray in the prevention of wound infection after appendicectomy, Br J Surg, 66, 430, 10.1002/bjs.1800660618

Walsh, 1996, Post-discharge surveillance of surgical wound infections, Can J Infect Control, 11, 29

Brown, 1987, Surgical wound infections documented after hospital discharge, Am J Infect Control, 15, 54, 10.1016/0196-6553(87)90002-2

Rosendorf, 1983, Effect of methods of postdischarge wound infection surveillance on reported infection rates, Am J Infect Control, 11, 226, 10.1016/0196-6553(83)90005-6

Ferraz, 1995, Postdischarge surveillance for nosocomial wound infection: does judicious monitoring find cases?, Am J Infect Control, 23, 290, 10.1016/0196-6553(95)90059-4

Andenaes, 1995, A prospective, randomized surveillance study of postoperative wound infections after plastic surgery: a study of incidence and surveillance methods, Plast Reconstr Surg, 96, 948, 10.1097/00006534-199509001-00028

Keeling, 1995, Inpatient and post-discharge wound infections in general surgery, Ann R Coll Surg Engl, 77, 245

Manian, 1997, 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, 25, 390, 10.1016/S0196-6553(97)90084-5

Manian, 1993, Comparison of patient telephone survey with traditional surveillance and monthly physician questionnaires in monitoring surgical wound infections, Infect Control Hosp Epidemiol, 14, 216, 10.1086/646718

Reimer, 1987, The impact of postdischarge infection on surgical wound infection rates, Infect Control, 8, 237, 10.1017/S0195941700066108

Sands, 1996, Surgical site infections occuring after hospital discharge, J Infect Dis, 173, 963, 10.1093/infdis/173.4.963

Weigelt, 1992, The necessity and efficiency of wound surveillance after discharge, Arch Surg, 127, 77, 10.1001/archsurg.1992.01420010091013

Gravel-Tropper, 1995, Underestimation of surgical site infection rates in obstetrics and gynecology, Am J Infect Control, 23, 22, 10.1016/0196-6553(95)90004-7

Taylor, 1994, Wound infection in total joint arthroplasty: effect of extended wound surveillance on wound infection rates, Can J Surg, 37, 217

Hulton, 1992, Effect of postdischarge surveillance on rates of infectious complications after cesarean section, Am J Infect Control, 20, 198, 10.1016/S0196-6553(05)80146-4

Law, 1990, The importance of surveillance after discharge from hospital in the diagnosis of postoperative wound infection, Ann R Coll Surg Engl, 72, 207

Donovan, 1979, One-dose antibiotic prophylaxis against wound infection after appendicectomy: a randomized trial of clindamycin, cefazolin sodium and a placebo, Br J Surg, 66, 193, 10.1002/bjs.1800660317

Bates, 1974, Topical ampicillin in the prevention of wound infection after appendicectomy, Br J Surg, 61, 489, 10.1002/bjs.1800610618

Centers for Disease Control and Prevention, 1997, 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, 46, 25

Fanning, 1995, Postdischarge surgical site infection surveillance, Can J Infect Control, 10, 75

Holbrook, 1991, Automated postdischarge surveillance for postpartum and neonatal nosocomial infections, Am J Med, 91, 125S, 10.1016/0002-9343(91)90357-4

Zoutman, 1990, Surgical wound infections occuring in day surgery patients, Am J Infect Control, 18, 277, 10.1016/0196-6553(90)90169-S

Seaman, 1991, Inability of patients to self-diagnose wound infections, J Emerg Med, 9, 215, 10.1016/0736-4679(91)90416-D

Goulbourne, 1979, Operations for hernia and varicose veins in a day-bed unit, Br Med J, 2, 712, 10.1136/bmj.2.6192.712

Garvey, 1986, Surveillance for postoperative infections in outpatient gynecologic surgery, Infect Control, 7, 54, 10.1017/S0195941700063888

Flanders, 1990, Ambulatory surgery postoperative wound surveillance, Am J Infect Control, 18, 336, 10.1016/0196-6553(90)90234-J

Gentry, 1988, Antibiotic prophylaxis in open-heart surgery: a comparison of cefamandole, cefuroxime, and cefazolin, Ann Thorac Surg, 46, 167, 10.1016/S0003-4975(10)65890-0

Maki, 1992, Comparitive study of cefazolin, cefamandole, and vancomycin for surgical prophylaxis in cardiac and vascular operations. A double-blind randomized trial, J Thorac Cardiovasc Surg, 104, 1423, 10.1016/S0022-5223(19)34639-2

Haines, 1994, Antibiotic prophylaxis for cerebrospinal fluid shunts: a metanalysis, Neurosurgery, 34, 87, 10.1227/00006123-199401000-00012

Langley, 1993, Efficacy of antimicrobial prophylaxis in placement of cerebrospinal fluid shunts: meta-analysis, Clin Infect Dis, 17, 98, 10.1093/clinids/17.1.98

Starr, 1995, Antimicrobial prophylaxis for ophthalmic surgery, Surv Ophthalmol, 39, 485, 10.1016/S0039-6257(05)80056-6

Gatell, 1984, Prophylactic cefamandole in orthopaedic surgery, J Bone Joint Surg Am, 66, 1219, 10.2106/00004623-198466080-00009

Kent, 1996, Prospective study of wound complications in continuous infrainguinal incisions after lower limb arterial reconstruction: incidence, risk factors, and cost, Surgery, 119, 378, 10.1016/S0039-6060(96)80135-8

Wymenga, 1992, Perioperative factors associated with septic arthritis after arthroplasty. Prospective multicenter study of 362 knee and 2,651 hip operations, Acta Orthop Scand, 63, 665, 10.1080/17453679209169732

Stambough, 1992, Postoperative wound infections complicating adult spine surgery, J Spinal Disord, 5, 277, 10.1097/00002517-199209000-00005

Trippel, 1986, Antibiotic-impregnated cement in total joint arthroplasty, J Bone Joint Surg Am, 68A, 1297, 10.2106/00004623-198668080-00026

Nungu, 1995, Prophylaxis with oral cefadroxil versus intravenous cefuroxime in trochanteric fracture surgery. A clinical multicentre study, Arch Orthop Trauma Surg, 114, 303, 10.1007/BF00448952

Norden, 1991, Antibiotic prophylaxis in orthopedic surgery, Rev Infect Dis, 13, S842, 10.1093/clinids/13.Supplement_10.S842

Aznar, 1991, Antibiotic prophylaxis in non-cardiac thoracic surgery: cefazolin versus placebo, Eur J Cardiothorac Surg, 5, 515, 10.1016/1010-7940(91)90103-Q

Cant, 1993, Antibiotic prophylaxis is indicated for chest stab wounds requiring closed tube thoracostomy, Br J Surg, 80, 464, 10.1002/bjs.1800800418

Pitt, 1980, Prophylactic antibiotics in vascular surgery. Topical, systemic, or both?, Ann Surg, 192, 356, 10.1097/00000658-198009000-00011

Kaiser, 1978, Antibiotic prophylaxis in vascular surgery, Ann Surg, 188, 283, 10.1097/00000658-197809000-00003

Bauer, 1989, Antibiotic prophylaxis in acute nonperforated appendicitis. The Danish Multicenter Study Group II, Ann Surg, 209, 307, 10.1097/00000658-198903000-00010

Skipper, 1991, A randomized prospective study to compare ceftizoxime with cephradine as single dose prophylaxis in elective cholecystectomy, J Hosp Infect, 17, 303, 10.1016/0195-6701(91)90275-D

Kaufman, 1984, Systemic prophylactic antibiotics in elective biliary surgery, Arch Surg, 119, 1002, 10.1001/archsurg.1984.01390210006002

Grant, 1992, Single dose cephalosporin prophylaxis in high-risk patients undergoing surgical treatment of the biliary tract, Surg Gynecol Obstet, 174, 347

Lewis, 1987, Biliary bacteria, antibiotic use, and wound infection in surgery of the gallbladder and common bile duct, Arch Surg, 122, 44, 10.1001/archsurg.1987.01400130050007

Saltzstein, 1992, Outpatient open cholecystectomy, Surg Gynecol Obstet, 174, 173

Meijer, 1990, Meta-analysis of randomized, controlled clinical trials of antibiotic prophylaxis in biliary tract surgery, Br J Surg, 77, 283, 10.1002/bjs.1800770315

Kaiser, 1983, Cefoxitin versus erythromycin, neomycin, and cefazolin in colorectal operations. Importance of the duration of the surgical procedure, Ann Surg, 198, 525, 10.1097/00000658-198310000-00012

Schoetz, 1990, Addition of parenteral cefoxitin to regimen of oral antibiotics for elective colorectal operations. A randomized prospective study, Ann Surg, 212, 209, 10.1097/00000658-199008000-00016

Edmondson, 1983, Prophylactic antibiotics in colon surgery, Arch Surg, 118, 227, 10.1001/archsurg.1983.01390020071012

Wapnick, 1979, Reduction of postoperative infection in elective colon surgery with preoperative administration of kanamycin and erythromycin, Surgery, 85, 317

Washington, 1974, Effect of preoperative antibiotic regimen on development of infection after intestinal surgery. Prospective, randomized, double-blind study, Ann Surg, 108, 567, 10.1097/00000658-197410000-00021

Maki, 1982, Comparative study of cefazolin, cefoxitin, and ceftizoxime for surgical prophylaxis in colo-rectal surgery, J Antimicrob Chemother, 10, 281, 10.1093/jac/10.suppl_C.281

Rotman, 1989, Prophylactic antibiotherapy in abdominal surgery. First- vs third-generation cephalosporins, Arch Surg, 124, 323, 10.1001/archsurg.1989.01410030073012

Lewis, 1982, Cefamandole in gastroduodenal surgery: a controlled, prospective, randomized, double-blind study, Can J Surg, 25, 561

McArdle, 1995, Oral ciprofloxacin as prophylaxis in gastroduodenal surgery, J Hosp Infect, 30, 211, 10.1016/S0195-6701(95)90316-X

Grandis, 1994, 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, 170, 729, 10.1093/infdis/170.3.729

Johnson, 1987, An assessment of the need for gram-negative bacterial coverage in antibiotic prophylaxis for oncological head and neck surgery, J Infect Dis, 155, 331, 10.1093/infdis/155.2.331

Elledge, 1991, The effects of topical oral clindamycin antibiotic rinses on the bacterial content of saliva on healthy human subjects, Otolaryngol Head Neck Surg, 105, 836, 10.1177/019459989110500611

Johnson, 1986, Cefazolin vs moxalactam? A double-blind randomzied trial of cephalosporins in head and neck surgery, Arch Otolaryngol Head Neck Surg, 112, 151, 10.1001/archotol.1986.03780020031008

Association of Operating Room Nurses, 1999

Larson, 1995, APIC guideline for handwashing and hand antisepsis in health care settings, Am J Infect Control, 23, 251, 10.1016/0196-6553(95)90070-5

Association of Operating Room Nurses, 1996, Recommended practices for skin preparation of patients, AORN J, 64, 813, 10.1016/S0001-2092(06)63272-9

Rutala, 1990, APIC guideline for selection and use of disinfectants, Am J Infect Control, 18, 99, 10.1016/0196-6553(90)90089-B

Favero, 1991, Sterilization, disinfection, and antisepsis in the hospital, 183

Association for the Advancement of Medical Instrumentation, 1996

American Institute of Architects Committee, 1996

Association for the Advancement of Medical Instrumentation, 1994

Platt, 1997, Guidelines for perioperative antibiotic prophylaxis, 229

Classen, 1992, The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection, N Engl J Med, 326, 281, 10.1056/NEJM199201303260501

Wong, 1996, Surgical site infections, 154

Hochberg, 1997, Principles of operative surgery: antisepsis, technique, sutures, and drains, 253

Roy, 1998, Surgical-site infections after coronary artery bypass graft surgery: discriminating site-specific risk factors to improve prevention efforts, Infect Control Hosp Epidemiol, 19, 229, 10.1086/647800

Herwaldt, 1996, Nosocomial infections associated with anesthesia, 655

Gaynes, 1996, Surveillance of nosocomial infections, 1017

Roy, 1997, Basics of surgical-site infection surveillance, Infect Control Hosp Epidemiol, 18, 659, 10.1086/647694

Lee, 1995, Surgical wound infections: surveillance for quality improvement, 145

Meier, 1997, Infection control issues in same-day surgery, 261

Burke, 1998, Infections of cardiac and vascular prostheses, 599

Lew, 1998, Infections of skeletal prostheses, 613

Nafziger, 1997, Infection in implantable prosthetic devices, 889