Table 1 Summary of statements

1) How to close a surgical incision?

Statement 1.1:

There is no significant difference in terms of SSI incidence and length of hospital stay between patients in which the skin is sutured by continuous versus interrupted stitches (GoR 1B)

Statement 1.2:

Superficial wound dehiscence is lower in subcuticular continuous suture versus interrupted stitches. (GoR 1B)

Statement 1.3:

The use of steri-strips doesn't reduce the incidence of SSI

2) Coated sutures: are they useful?

Statement 2:

Triclosan-coated sutures significantly reduce SSI prevalence compared with the non-coated sutures (GoR1B)

3) What is the role of intraoperative intraperitoneal irrigation vs topic wound lavage with antibiotic solutions to prevent surgical site infections?

Statement 3:

There are insufficient data to to support the role of intraperitoneal the role of intraperitoneal or topic wound irrigation with antibiotics in preventing SSI

4) Could wound irrigation with saline and/or povidone iodine solution be useful to prevent surgical site infections?

Statement 4:

There are insufficient data to determine the role of saline or povidone solution irrigation of incisional wounds before closure to prevent SSI (GoR 2B).

5) Are wound protector devices useful?

Statement 5.1:

The use of wound protectors has protective effects in reducing incisional SSI (GoR 1A);

Statement 5.2:

The use of dual-ring constructed wound protectors appears to be superior to single-ring devices in preventing SSI (GoR1B).

6) Are sterile surgical drapes useful?

Statement 6:

There is no evidence that plastic adhesive incise drapes with or without antimicrobial properties are useful to decrease SSI (GoR 2C).

7) To drain or not to drain in closing surgical incision?

Statement 7:

There are insufficient data to determine the role of the use of subcutaneous drainage of incisional wounds before closure to prevent SSI in high-risk patients (GoR 2B)

8) When is double gloving recommended? When is changing gloves recommended during an operation?

Statement 8.1:

There are insufficient data to determine the role of double gloving to prevent SSI (GoR 2C).

Statement 8.2:

The mechanical resistance of latex gloves depends on the duration of wear. It may be beneficial for surgical team members and their protection to change gloves at certain intervals during surgery (GoR 2C).

9) Is negative-pressure wound dressing useful to prevent surgical site infections?

Statement 9:

The application of negative-pressure wound therapy in preventing SSI may be effective in reducing postoperative wound complications and it may be an option especially in patients with a high risk of SSI (GoR 2C)

10) Is intraoperative normothermia useful to prevent surgical site infections?

Statement 10.1:

Intraoperative normothermia decreases the rate of SSI (GoR 1A).

Statement 10.2:

The use of active warming devices in operating room is useful to keep normothermia and reduce SSI (GoR 1B)

11) Is perioperative supplemental oxygen effective to reduce surgical site infections?

Statement 11:

Perioperative hyperoxygenation does not reduce SSI (GoR 2B)

12) Leaving the skin open for delayed primary closure can reduce SSI?

Statement 12.1:

Delayed primary skin closure may reduce the incidence of SSI (GoR 2C)

Statement 12.2:

Delayed primary closure of a surgical incision is an option to take into consideration in contaminated abdominal surgeries, in patients with high risk of SSI (GoR 2C)

13) When should additional antibiotic dose be administered intraoperatively?

Statement 13:

Optimal knowledge and use of the pharmacokinetic/pharmacodynamic characteristics of antibiotics are important to evaluate when additional antibiotic doses should be administered intraoperatively in patients with intra-abdominal infections undergoing emergency surgery (GoR 1C)