Surgical site infections (SSIs) remain among the most common healthcare-associated infections worldwide, with well-documented consequences such as prolonged hospital stays, increased morbidity, and additional healthcare costs. A systematic meta-analysis1 examined the impact of patient engagement on SSI rates and concluded that active patient involvement represents an underutilised but effective strategy for SSI prevention.
Out of 290 publications (2010–2024) identified via structured searches in four databases, following PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), eight studies of varying design met all inclusion criteria. Eligible studies were English-language publications focusing on patient education and engagement, including the involvement of relatives. Exclusion criteria included: lack of full-text access, duplicates, non-English publications, retracted papers, or studies not directly addressing patient or relative participation.
The analysis revealed three key categories of patient participation in the reviewed literature:
Several studies also demonstrated improved therapy compliance when patients were actively involved in their own treatment process.
The effectiveness of this approach is reflected in clear outcomes: For example, in a Brazilian study, the SSI rate was reduced from 16.4% to 5.1%. A British study reported a reduction from 16.4% to 4.7% and a study conducted in Thailand documented a 70% decrease in infection rates.
Despite the potential benefits, patient participation is not yet systematically implemented in SSI prevention. Key challenges include:
These barriers must be addressed through structured, patient-centred approaches.
Observational data suggest that digital wound-monitoring apps are well accepted by patients. These tools enable more frequent and convenient follow-ups and may help alleviate post-operative anxiety.
However, it was also observed that healthcare staff in secondary care settings often fail to communicate infection risks effectively or to provide clear, actionable information.
Opportunities for patient participation exist along the entire preparatory and treatment pathway – from lifestyle modifications (smoking, weight reduction) to infection prevention training (hygiene), preoperative measures (showering, hair removal), and postoperative wound care and early detection of infection signs.
The combination of evidence-based and already widely implemented prevention bundles with new strategies to strengthen patient involvement could therefore represent an effective approach to SSI prevention.
On L&R Prevent & Protect, you will find a wide range of helpful materials on evidence-based SSI guidelines and patient engagement, including:
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1 A’aqoulah A et al.: The Impact of Patients’ Engagement in the Prevention of Surgical Site Infections: A Systematic Review. Infect Drug Resist. 2025; 18:5761–5770
2 Tartari E et al.: Patient engagement with surgical site infection prevention: an expert panel perspective ARIC 2017; 6:45
