- Identify and treat all remote infections for neuromodulation trials and implants
- Optimize glucose control for neuromodulation implants
- Discontinue tobacco use for neuromodulation implants
- Decolonize MSSA and MSRA carriers through the application of mupirocin nasal ointment and chlorohexidine baths
- Utilize preoperative antibiotics for neuromodulation trials and implants
- Utilize preoperative weight-based antibiotic dosing for neuromodulation trials and implants
- Use appropriate preoperative timing (within 1 hour prior to surgical incision excluding vancomycin) of prophylactic antimicrobial administration for neuromodulation trials and implants
- Remove hair (when required) with electric clippers immediately before the surgical procedure
- Perform preoperative surgical scrub for a minimum of 2 to 5 minutes with an appropriate antiseptic prior to neuromodulation trials and implants
- Keep nails short and do not wear artificial nails for neuromodulation trials and implants
- Do not wear hand or arm jewelry for neuromodulation trials or implants
| - Wear a surgical mask for neuromodulation trials and implants
- Wear a cap or hood to fully cover hair for neuromodulation trials and implants
- Use sterile gown and gloves for neuromodulation trials and implants
- Double glove
- Utilize chlorhexidine gluconate for preoperative skin antiseptic agent
- If an incise drape is used, then iodophor-impregnated drape for neuromodulation implants are recommended
- Use laminar flow and HEPA filters in OR for neuromodulation implants
- Limit procedure room traffic for neuromodulation trials and implants
- Keep procedure room doors closed during neuromodulation trials and implants
- Limit tissue trauma, maintain hemostasis, eradicate dead space, and avoid electrocautery at tissue surface
- Irrigate with saline through a bulb syringe prior to closure of surgical wound
- Employ implant strategies to limit operative time
| - Apply an occlusive dressing following neuromodulation trials and implants for 24 to 48 hours
- Do not routinely use topical antimicrobial agents for surgical wounds that are healing by primary intention
- Understand maximum time criterion for defining a deep surgical site infection of an implantable device (1 year postimplant)
- Do not continue antibiotics into the postoperative period for neuromodulation trials and implants beyond 24 hours
- Educate patient and family on proper incision care, symptoms of SSI, and importance of reporting symptoms
- Wash hands before and after dressing changes
- Use sterile technique for dressing changes
- When SSI is suspected, prescribe an antibiotic that covers the likely causative organisms. Consider local resistance patterns and culture results in choosing an antibiotic.
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