Evidence review reveals that multimodal infection control substantially reduces surgical site infections worldwide, highlighting an ethical imperative for safety frameworks.
Background: Surgical site infections (SSIs) remain a major cause of morbidity, mortality, and inequity worldwide. Many SSIs are preventable and represent an important indicator of surgical quality and patient safety. Methods: Evidence and implementation experiences on SSI prevention were reviewed, focusing on infection prevention and control (IPC), antimicrobial stewardship (AMS), antimicrobial resistance (AMR), quality improvement, surveillance, safety culture, human factors, and emerging technologies. Results: Multimodal, context-adapted IPC interventions can substantially reduce SSI incidence without major capital investment. Persistent gaps in infrastructure, guideline implementation, surveillance, and environmental controls remain important challenges. AMR further emphasizes the need to integrate AMS into surgical safety frameworks. Artificial intelligence and objective diagnostic technologies may improve surveillance and early SSI detection. Summary: SSI prevention is both a clinical necessity and an ethical imperative. Global surgery strategies should integrate IPC, AMS, surveillance, safety culture, and innovative technologies to advance equity, quality, and safety in surgical care worldwide.
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Sartelli et al. (2026) studied this question.
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