# A perioperative nurse is implementing the surgical site infection (SSI) prevention bundle for a patient undergoing colon surgery. Which interventions are evidence-based components of the bundle? Select all that apply.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374199&lang=en  
> language: en  
> subject: Safety and Infection Prevention and Control  
> category: SIPC

## Question

A perioperative nurse is implementing the surgical site infection (SSI) prevention bundle for a patient undergoing colon surgery. Which interventions are evidence-based components of the bundle? Select all that apply.

1

Use clippers (not razors) for hair removal at the surgical site immediately before surgery if removal is necessary.

2

Administer prophylactic antibiotic within 60 minutes before surgical incision (within 120 minutes for vancomycin or fluoroquinolones) and re-dose intraoperatively per protocol.

3

Shave the surgical site with a razor the night before surgery to remove hair thoroughly and decrease bacterial colonization.

4

Maintain perioperative normothermia and adequate oxygenation according to the anesthesia and surgical protocol.

5

Monitor perioperative glucose and treat hyperglycemia according to protocol in patients with or without diabetes.

## Explanation

Options 1, 2, 4, and 5 are evidence-based SSI-prevention measures: avoid hair removal unless necessary and use clippers rather than razors; administer prophylactic antibiotics within the protocol window and re-dose when indicated; maintain normothermia and adequate oxygenation; and monitor and manage perioperative hyperglycemia. Option 3 is incorrect because razor shaving can create microabrasions that increase infection risk.

## In-depth explanation

The most-tested SSI traps: (1) shaving with a razor causes microabrasions and SSI — use clippers instead; (2) hypothermia worsens SSI rates so warm the patient; (3) hyperglycemia (even in non-diabetics) increases SSI by impairing neutrophils. The 60-minute antibiotic window is a quality measure tracked by SCIP.

## Clinical scenario

Patient prepared for **elective colon surgery**. The unit follows the **SCIP / IHI surgical site infection prevention bundle** with daily compliance audits and SSI surveillance.

## Key concepts

- **SSI prevention bundle** — SCIP and IHI bundle including antibiotic timing, glycemic control, hair removal with clippers, normothermia, oxygen.
- **Perioperative normothermia** — Core temperature ≥ 36.0 C; reduces SSI by maintaining neutrophil function and tissue perfusion.
- **Clipping vs shaving** — Clippers cause fewer microabrasions; razors are associated with higher SSI rates and have been removed from preferred practice.

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