Surgical Site Infections Impactful Statements

The following impactful statements are based on the Management of Surgical Site Infections Systematic Literature Review.

1. When performing cultures, it is preferred to collect tissue biopsies rather than swabs after stopping antimicrobials for two weeks prior to culture when clinically safe, and to incubate cultures for at least 14 days. All lead to higher yields but are not universally in practice today.

2. The use of Rifampin as a second drug would benefit patients that meet both requirements 1) staphylococcus infections patients and 2) have retained implants.

The following recommendation is the basis of the statements above.

1. Strong evidence supports that synovial fluid and tissue cultures are strong rule-in tests for the diagnosis of infection; negative synovial fluid and tissue cultures do not reliably exclude infection.

2. Moderate evidence supports that rifampin, as a second antimicrobial, increases the probability of treatment success for staphylococcal infections in the setting of retained orthopaedic implants.