Abstract 190 Table 1

Intraoperative Maneuvers to Optimize Surgical Incision Healing

1. Patients should be screened for a history of MRSA, and MRSA-positive patients should apply Mupirocin intranasally twice daily and bathe in Chlorohexidine gluconate (CHG) daily for 5 days immediately before the operation. A single dose of vancomycin should be administered to MRSA carriers 120 minutes before procedure. For all patients, regardless of the MRSA screening results, cefazolin or cefuroxime should be given as prophylaxis 60 minutes prior to surgical incision, redosing for procedures 4 hours or longer.
2. Maintaining normothermia, glycemic control, and enhancing oxygenation throughout the procedure should be prioritized.
3. Chlorhexidine with or without isopropyl alcohol and careful debridement of all non-viable tissue achieves enhanced antisepsis and reduces incisional healing challenges.
4. Using diluted chlorhexidine 0.05% for irrigating the wound before closing any layer of incision, antimicrobial sutures when closing, and negative pressure wound therapy (NPWT) over high-risk incisions are useful in reducing postoperative wound complications.
5. Staff should wash hands using 60–80% ethanol and double glove with an indicator system, changing the outer glove every hour. OR traffic should be limited.
6. Primarily closed incisions should be covered with sterile dressing for 24–48 hours postoperatively. If dressing must be changed prior to 48 hours, use the sterile technique. Dressings may be selected in the context of managing wound exudate, patient experience, wound location, and/or patient risk factors.