{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:35:57Z","timestamp":1761824157794,"version":"3.40.5"},"reference-count":77,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T00:00:00Z","timestamp":1574380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine what measures an otolaryngology\u2013head and neck surgery team might adopt to decrease the incidence of surgical site infection (SSI) on a short\u2010term surgical mission. Despite concerns about safety and efficacy, short\u2010term surgical missions remain the predominant structure for humanitarian surgical care in low\u2010 and middle\u2010income countries (LMIC). Hospitals in high\u2010income countries strive to improve surgical outcomes through implementation of World Health Organization (WHO) safe surgery guidelines. Reduction of SSI risk is a key part of this effort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Literature review and practical experience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>WHO recommendations for reducing SSI are based largely on research done in the North America and Europe. LMIC populations are younger; comorbidities are fewer; infectious disease and trauma are prevalent; and delays in access to care are common. SSI are much more frequent in resource\u2010limited settings. Recommendations regarding preoperative assessment, operating room environment, instrument sterilization, surgical antibiotic prophylaxis, surgical site preparation, gloving, draping, and postsurgical care are reviewed in the context of a surgical mission at a typical LMIC government hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Many of the WHO guidelines on reduction of SSI are logical and applicable to the short\u2010term surgical missions; others may need to be modified. Careful prospective data collection and clinical trials are needed to learn which interventions are valid and which should be changed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>5 <jats:bold><jats:italic>Laryngoscope, 130:1388\u20131395, 2020<\/jats:italic><\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28418","type":"journal-article","created":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T15:00:52Z","timestamp":1574434852000},"page":"1388-1395","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Reducing Surgical Site Infections During Otolaryngology Surgical Missions"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5977-1796","authenticated-orcid":false,"given":"Glenn","family":"Isaacson","sequence":"first","affiliation":[{"name":"Departments of Otolaryngology\u2013Head &amp; Neck Surgery and Pediatrics Lewis Katz School of Medicine at Temple University  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winifred","family":"Doyle","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head &amp; Neck Surgery and Pediatrics Lewis Katz School of Medicine at Temple University  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Summer","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head &amp; Neck Surgery and Pediatrics Lewis Katz School of Medicine at Temple University  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,11,22]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-014-2516-0"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0165480"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70213-X"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-005-0056-8"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0373-z"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-018-4720-9"},{"key":"e_1_2_3_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2018.05.014"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nwh.2016.01.003"},{"key":"e_1_2_3_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2017.03.024"},{"key":"e_1_2_3_11_1","first-page":"6417240","article-title":"Surgical management outcome of intestinal obstruction and its associated factors at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2018","volume":"2019","author":"Mariam TG","year":"2019","journal-title":"Surg Res Pract"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-018-3327-2"},{"key":"e_1_2_3_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13378"},{"key":"e_1_2_3_14_1","unstructured":"World Health Organization.WHO Guidelines for Safe Surgery 2009. 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