Preoperative Strategies for the Prevention of Surgical Site Infections in Athletes: A Review

Abstract

Surgical site infections (SSIs) remain among the most common healthcare-associated infections, contributing to increased morbidity, prolonged hospitalization, higher healthcare costs, and delayed recovery. This review evaluates current evidence regarding preoperative strategies for SSI prevention, with particular emphasis on measures relevant to athletic and physically active populations undergoing surgical procedures. Key interventions examined include preoperative body washing, skin antisepsis, hair removal practices, and perioperative glycemic control. Available evidence suggests that while preoperative bathing, including chlorhexidine-based cleansing, improves skin hygiene, its direct effect on reducing SSI rates remains uncertain. In contrast, alcohol-based chlorhexidine skin antisepsis demonstrates consistent superiority over povidone-iodine in lowering microbial burden and reducing SSI incidence. Hair removal, when necessary, should be performed using clippers immediately before surgery, as shaving is associated with increased infection risk. Additionally, maintaining perioperative blood glucose levels below 180 mg/dL appears essential for minimizing postoperative infections. A multimodal, evidence-based approach integrating these preventive measures offers the greatest potential for reducing SSI risk and improving surgical outcomes.