Prevention of surgical site infections

Surgical site infection (SSI) is a common and concerning healthcare-associated infection. The first part of this thesis explored the impact of SSI on both patient health and economic burden. Specifically, it evaluated the impact of SSI and anastomotic leakage on cost and quality of life. In addition, a qualitative study investigated the physical and emotional experiences of patients with negative pressure wound therapy with instillation. Last, a cross-sectional study examined patients’ experiences and preferences regarding surgical wound care education at discharge in the Netherlands.
The second part of this thesis investigated the efficacy of individual interventions aimed at reducing SSI risk, addressing gaps in existing knowledge, and highlighting discrepancies in current guidelines. Systematic reviews and (network) meta-analyses were conducted to assess the effects of different preoperative skin antiseptics, incisional wound irrigation solutions, and incisional negative pressure wound therapy on SSI. Additionally, the potential effect of operating room door openings on SSI rates was investigated in a systematic review and individual patient data meta-analysis. The findings from four chapters of Part II have contributed to the development of recommendations for the Dutch guideline for the prevention of SSI, which was published in 2024.