The Multidisciplinary Defense Against Surgical Site Infections (SSIs): From Sociocultural Determinants to Point-of-Care Diagnostics and Antimicrobial Stewardship
Abstract
Background: Surgical Site Infections (SSIs) represent a pervasive threat to global health security, driving antimicrobial resistance (AMR), prolonging hospital stays, and increasing morbidity and mortality. Traditional prevention strategies, often siloed within specific perioperative domains, fail to address the complex, multifactorial etiology of SSIs, which spans biological, technological, and sociobehavioral spheres. Aim: This narrative review synthesizes contemporary evidence (2015-2024) to construct an integrated model for SSI prevention. It examines the confluence of sociocultural determinants, the critical roles of allied health personnel (e.g., healthcare assistants), and advancements in laboratory diagnostics, pharmacy, dentistry, and anesthesia technology. Methods: A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted. Literature on SSI risk factors, prevention bundles, rapid diagnostics, antimicrobial stewardship (AMS), and interdisciplinary collaboration was analyzed thematically. Results: Evidence confirms that SSI pathogenesis exists at the intersection of patient-level factors (e.g., health literacy, oral health), procedural elements (e.g., normothermia, antibiotic timing), and microbial ecology. Isolated interventions are suboptimal. Effective defense requires a unified bundle where point-of-care diagnostics guide targeted therapy, pharmacy-led AMS optimizes prophylaxis, dental clearance eliminates occult foci, and anesthesia technology maintains physiological homeostasis, all supported by patient engagement facilitated by healthcare teams. Conclusion: A paradigm shift from compartmentalized protocols to a cohesive, transdisciplinary "SSI Defense Bundle" is imperative. This model emphasizes pre-operative optimization, real-time intraoperative monitoring, and post-operative stewardship, with clear communication channels across all specialities to mitigate this quintessential health security threat.
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Authors
Copyright (c) 2024 Mohsen Sameer Alhaddad, Bandar Ali Sharahi, Ibrahim Ali Madarbesh, Bishi Ahmad Mohammad Moukli, Jawaher Tami H Alkahtani, Adel Fayadh Shihadah Alanazi, Anoud Mater Shamali Alenazi, Rawdha Mohammed Saleh Fallatah, Sarah Abdulaziz Asiri, Munirah Ibraheem Almehimed, Nabil Ali Ahmed Sofyani, Abdulaziz Ali Abdullah Al-Muqrin
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