Details

Autor(en) / Beteiligte

• Biccard, Bruce M
• Msosa, Vanessa
• Samateh, Ahmadou L

Titel

Prevention of surgical site infection in low-resource settings

Ist Teil von

• The Lancet (British edition), 2021-11, Vol.398 (10312), p.1664-1665

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• WHO defines universal health coverage (UHC) as “access to needed essential health services, without financial hardship”.1 UHC requires about US$100 per head for an essential package of 218 interventions, and approximately $50 per head for a basic package of 108 of the highest priority interventions.2 Yet, estimates in 2016 suggested that only nine of the 49 low-income and middle-income countries (LMICs) could afford the essential package, and that 16 countries could afford the 108 highest priority interventions of the basic package.2 At an average government spend on health in low-income countries of only $9 per head in 2018 (1·2% of Gross National Product), literally every cent counts.3 Surgical care is an indivisible component of UHC,4 yet the outcomes in low-income countries are poor.5,6 Provision of quality surgical care in these countries is difficult because resources and finances are limited. Surgical site infections (SSI) predominate perioperative complications,6 with a higher burden and more antibiotic resistance in low-income countries.9 The need for appropriate global guidelines for prevention of SSI is therefore important.10 However, some recommendations are based on little evidence, with a negative financial effect in low-income countries. Similar to FALCON, evidence is needed to challenge other controversial practice guidelines in low-income countries, such as the WHO recommendation for the use of liberal inspired oxygen concentrations of 80% during surgery to prevent SSI.11,12 The retraction of several trials has raised further concerns regarding the evidence base.13 The COVID-19 pandemic has highlighted the importance of oxygen as a scarce health-care resource, emphasising the need to establish the evidence for the recommendation for liberal inspired oxygen to prevent SSI.