{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:02:40Z","timestamp":1785391360027,"version":"3.55.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surgical site infections (SSIs) remain a major cause of healthcare-associated morbidity, mortality, and increased healthcare costs worldwide, particularly in low- and middle-income countries (LMICs). Although evidence-based prevention guidelines are widely available, inconsistent implementation and variability in adherence continue to limit their effectiveness across healthcare settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This scoping review synthesized recent evidence on SSI prevention strategies published between 2019 and 2025. A systematic search of Scopus, Web of Science, and ScienceDirect identified 24 eligible studies. Data were extracted and thematically analyzed to examine intervention effectiveness, implementation challenges, and emerging innovations in SSI prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Core clinical strategies\u2014including antibiotic prophylaxis, topical antisepsis and decolonization, and negative pressure wound therapy (NPWT)\u2014were consistently effective; however, their success depended heavily on implementation fidelity. Multicomponent strategies, particularly prevention bundles, significantly improved outcomes by enhancing consistency and reducing variability in care delivery. Persistent barriers, including limited resources, inadequate training, and workflow constraints, remained major obstacles across both high- and low-resource settings. In LMICs, context-specific and low-cost interventions, such as glove and instrument changes before wound closure, demonstrated substantial effectiveness and scalability. Emerging data-driven approaches, including artificial intelligence and machine learning, showed strong potential in improving SSI risk prediction and surveillance, although infrastructural limitations continue to restrict broader implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SSI prevention is fundamentally an implementation-driven challenge requiring alignment between evidence-based interventions, system-level capacity, and context-sensitive adaptation. By integrating clinical, implementation, and technological perspectives, this review provides a unified framework to guide future research, policy development, and healthcare practice aimed at reducing the global burden of SSIs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1884446","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:39:27Z","timestamp":1785389967000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical site infection prevention: a scoping review of strategies, implementation barriers, and emerging approaches"],"prefix":"10.3389","volume":"14","author":[{"given":"Sara Yousef Falah","family":"Abualkishik","sequence":"first","affiliation":[{"name":"Department of Community Health, Pusat Kanser Tun Abdullah Ahmad Badawi, Universiti Sains Malaysia","place":["Kepala Batas, Penang, Malaysia"]},{"name":"Department of Nursing, Faculty of Nursing, Irbid National University","place":["Irbid, Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noorsuzana","family":"Mohd Shariff","sequence":"additional","affiliation":[{"name":"Department of Community Health, Pusat Kanser Tun Abdullah Ahmad Badawi, Universiti Sains Malaysia","place":["Kepala Batas, Penang, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohayu","family":"Binti Hami","sequence":"additional","affiliation":[{"name":"Department of Community Health, Pusat Kanser Tun Abdullah Ahmad Badawi, Universiti Sains Malaysia","place":["Kepala Batas, Penang, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1017\/ice.2023.67","article-title":"Strategies to prevent surgical site infections in acute-care hospitals: 2022 update","volume":"44","author":"Calderwood","year":"2023","journal-title":"Infect Control Hosp Epidemiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"73","DOI":"10.4103\/jwas.jwas_51_23","article-title":"Healthcare-associated infection in surgery department: a big challenge for African surgical teams","volume":"13","author":"Togo","year":"2023","journal-title":"J West Afr College Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.idh.2021.03.003","article-title":"Improving surgical site infection prevention in Asia-Pacific through appropriate surveillance programs: challenges and recommendation","volume":"26","author":"Russo","year":"2021","journal-title":"Infect Dis Health"},{"key":"ref4","year":"2024"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e0232960","DOI":"10.1371\/journal.pone.0232960","article-title":"Surgical site infection and costs in low-and middle-income countries: a systematic review of the economic burden","volume":"15","author":"Monahan","year":"2020","journal-title":"PLoS One"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.jtumed.2022.08.012","article-title":"Appropriateness of choice and duration of surgical antibiotic prophylaxis and the incidence of surgical site infections: a prospective study","volume":"18","author":"Thabit","year":"2023","journal-title":"J Taibah Univ Med Sci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"558","DOI":"10.3390\/pharmaceutics13040558","article-title":"Topical antiseptic formulations for skin and soft tissue infections","volume":"13","author":"Hoang","year":"2021","journal-title":"Pharmaceutics"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"106136","DOI":"10.1016\/j.ijsu.2021.106136","article-title":"Worldwide incidence of surgical site infections in general surgical patients: a systematic review and meta-analysis of 488,594 patients","volume":"95","author":"Gillespie","year":"2021","journal-title":"Int J Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"100235","DOI":"10.1016\/j.infpip.2022.100235","article-title":"Task-based training to prevent surgical site infection: a formative evaluation","volume":"4","author":"Khan","year":"2022","journal-title":"Infect Prev Pract"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1111\/jocn.15135","article-title":"Wound care practices across two acute care settings: a comparative study","volume":"29","author":"Gillespie","year":"2020","journal-title":"J Clin Nurs"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1001\/jamasurg.2017.0904","article-title":"Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017","volume":"152","author":"Berr\u00edos-Torres","year":"2017","journal-title":"JAMA Surg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1097\/XCS.0000000000000866","article-title":"Routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection: reviewing the ChEETAh trial","volume":"238","author":"Ferreira","year":"2024","journal-title":"J Am Coll Surg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e235","DOI":"10.1016\/S2214-109X(23)00538-7","article-title":"Routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection (ChEETAh): a model-based cost-effectiveness analysis of a pragmatic, cluster-randomised trial in seven low-income and middle-income countries","volume":"12","author":"Kachapila","year":"2024","journal-title":"Lancet Glob Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s13756-023-01294-0","article-title":"Development of machine learning models for the detection of surgical site infections following total hip and knee arthroplasty: a multicenter cohort study","volume":"12","author":"Wu","year":"2023","journal-title":"Antimicrob Resist Infect Control"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e000383","DOI":"10.1136\/bmjsit-2025-000383","article-title":"Economic analysis of triclosan-coated versus uncoated sutures at preventing surgical site infection in patients undergoing abdominal surgery","volume":"7","author":"Kachapila","year":"2025","journal-title":"BMJ Surg Intervent Health Technol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann Intern Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan\u2014a web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst Rev"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"285","DOI":"10.3233\/EFI-180221","article-title":"The mixed methods appraisal tool (MMAT) version 2018 for information professionals and researchers","volume":"34","author":"Hong","year":"2018","journal-title":"Educ Inf"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.jtv.2024.05.002","article-title":"Evaluating antibiotic prophylaxis adherence: implications for surgical site infections and wound care management","volume":"33","author":"Velozo","year":"2024","journal-title":"J Tissue Viability"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"103804","DOI":"10.1016\/j.amsu.2022.103804","article-title":"Role of antibiotic prophylaxis on surgical site infection prevention in a low-risk population undergoing laparoscopic cholecystectomy: a randomized controlled study","volume":"78","author":"Ullah","year":"2022","journal-title":"Ann Med Surg"},{"key":"ref21","first-page":"106253","article-title":"Topical use of hyperoxygenated fatty acids decreases surgical site infection in patients following laparoscopic cholecystectomy. A randomized controlled trial","volume-title":"Int. J. Surg","author":"Bell\u00f3n L\u00f3pez de Ant\u00f3n Bueno","year":"2022"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.jhin.2023.07.011","article-title":"Impact of control measures including decolonization and hand hygiene for orthopaedic surgical site infection caused by MRSA at a Japanese tertiary-care hospital","volume":"146","author":"Kawamura","year":"2024","journal-title":"J Hosp Infect"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1016\/j.otsr.2020.01.013","article-title":"Individual decontamination measures reduce by two the incidence of surgical site infections in spinal surgery","volume":"106","author":"Bouyer","year":"2020","journal-title":"Orthoped Traumatol Surg Res"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"E550","DOI":"10.1503\/cjs.016922","article-title":"Effectiveness of prophylactic intranasal photodynamic disinfection therapy and chlorhexidine gluconate body wipes for surgical site infection prophylaxis in adult spine surgery","volume":"66","author":"Moskven","year":"2023","journal-title":"Can J Surg"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"100365","DOI":"10.1016\/j.infpip.2024.100365","article-title":"Impact of postoperative skin disinfection with chlorhexidine on bacterial colonisation following shoulder arthroplasty surgery: a controlled randomised study","volume":"6","author":"Markstr\u00f6m","year":"2024","journal-title":"Infect Prev Pract"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/j.jvs.2019.05.066","article-title":"Negative pressure wound therapy reduces surgical site infections","volume":"71","author":"Benrashid","year":"2020","journal-title":"J Vasc Surg"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.jhin.2024.05.001","article-title":"Preventive strategies in paediatric cardiovascular surgery: impact on surgical site infections and beyond","volume":"150","author":"Montoya","year":"2024","journal-title":"J Hosp Infect"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"314","DOI":"10.35975\/apic.v24i3.1282","article-title":"Operative site irrigation with povidone-iodine solution in spinal surgery for surgical site infection prevention: can it be used safety?","volume":"24","author":"Sigari","year":"2020","journal-title":"Anaesth Pain Intens Care"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.ygyno.2024.02.023","article-title":"Implementation of a surgical site infection prevention bundle in gynecologic oncology patients: an enhanced recovery after surgery initiative","volume":"185","author":"Ejaredar","year":"2024","journal-title":"Gynecol Oncol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.surg.2022.01.027","article-title":"Implementing a surgical site infection prevention bundle for emergency appendectomy: worth the effort or waste of time?","volume":"172","author":"Jurt","year":"2022","journal-title":"Surgery"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"439","DOI":"10.21873\/invivo.12722","article-title":"Intervention strategies to reduce surgical site infection rates in patients undergoing rectal cancer surgery","volume":"36","author":"Okada","year":"2022","journal-title":"In Vivo"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e75121","DOI":"10.2196\/75121","article-title":"Machine learning\u2013enhanced surveillance for surgical site infections in patients undergoing colon surgery: model development and evaluation study","volume":"9","author":"Celik","year":"2025","journal-title":"JMIR Form Res"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"e75567","DOI":"10.2196\/75567","article-title":"Evaluating the performance of state-of-the-art artificial intelligence chatbots based on the WHO global guidelines for the prevention of surgical site infection: cross-sectional study","volume":"27","author":"Wang","year":"2025","journal-title":"J Med Internet Res"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"100196","DOI":"10.1016\/j.xnsj.2022.100196","article-title":"Development and validation of a point-of-care clinical risk score to predict surgical site infection following open spinal fusion","volume":"13","author":"Mueller","year":"2023","journal-title":"North Am Spine Soc J"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"20538","DOI":"10.1038\/s41598-024-71592-z","article-title":"Construction and validation of nomogram to predict surgical site infection after hysterectomy: a retrospective study","volume":"14","author":"Shao","year":"2024","journal-title":"Sci Rep"},{"key":"ref36","year":"2024"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1884446\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:39:28Z","timestamp":1785389968000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1884446\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":36,"alternative-id":["10.3389\/fpubh.2026.1884446"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1884446","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]},"article-number":"1884446"}}