World Health Organization · Interim version · 135 pages
A practical manual to help healthcare facilities translate WHO SSI prevention guidelines into everyday practice.
- Issuer
- World Health Organization
- Edition
- Interim version
- Audience
- Healthcare facility managers, infection prevention teams, surgical staff
- Reviewed
- 23 Oct 2026 · GMJ
What this guideline says
GMJ summary
This implementation manual provides healthcare facilities with practical tools and strategies to adopt the WHO global guidelines on prevention of surgical site infections (SSI). SSIs remain a major cause of preventable morbidity, mortality and additional healthcare costs worldwide, particularly in low- and middle-income settings where infection prevention and control infrastructure may be limited.
The manual bridges the gap between evidence-based recommendations and real-world application, offering facility-level managers, infection prevention teams and surgical staff a structured approach to implementing SSI prevention measures. It addresses common barriers to guideline adoption and provides actionable frameworks for assessing current practice, planning interventions and monitoring outcomes in diverse healthcare settings.
Key points
For clinicians — doses and thresholds as stated in the guideline
- Provides facility-level tools to implement WHO SSI prevention recommendations in operating theatres and surgical wards
- Addresses practical barriers to adopting infection prevention measures in resource-limited settings
- Includes assessment frameworks for evaluating current surgical site infection prevention practices
- Offers implementation strategies for pre-operative, intra-operative and post-operative SSI prevention bundles
- Supports infection prevention and control teams in planning, executing and monitoring SSI prevention programmes
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As someone who has worked extensively with WHO on health systems strengthening in Georgia and the region, I recognise that surgical site infections remain an under-reported yet significant contributor to hospital-acquired complications across the South Caucasus. This implementation manual addresses a critical gap: our region has adopted many WHO clinical guidelines on paper, yet translation into consistent bedside practice remains inconsistent, particularly in smaller facilities outside capital cities. The manual's emphasis on practical, facility-level tools is exactly what infection prevention teams in Tbilisi, Yerevan and Baku need to move beyond policy documents toward measurable SSI reduction. The main implementation challenge for Georgia will be ensuring that the manual reaches not only our accredited university hospitals but also the district surgical centres where resources are tighter and where systematic infection surveillance and feedback mechanisms are often absent.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 23 Oct 2026
Applicability
Georgia and the South Caucasus
Surgical site infections represent a significant burden in Georgia and the South Caucasus, where surgical volumes are rising but infection prevention infrastructure varies widely between urban tertiary centres and rural district hospitals. National programmes would need to assess baseline SSI surveillance capacity, availability of essential supplies (antiseptics, appropriate antimicrobials, sterile instruments), training levels of surgical and nursing staff, and existing infection prevention and control committees. The manual’s practical, resource-stratified approach is particularly relevant for Georgia’s mixed health system, where UHC reforms since 2013 have increased surgical access but quality assurance mechanisms require strengthening.
Questions this guideline answers
Quick answers
What is the purpose of this implementation manual?
To provide practical tools and frameworks that help healthcare facilities translate WHO's evidence-based SSI prevention guidelines into everyday clinical practice, addressing common implementation barriers.
Who should use this manual?
Facility managers, infection prevention and control teams, surgical department heads, operating theatre nurses, and quality improvement officers responsible for implementing SSI prevention programmes.
Does this replace the WHO SSI prevention guidelines?
No, this manual complements the WHO global guidelines by providing practical implementation support, assessment tools and strategies for adopting the guidelines' recommendations at facility level.
Is this manual suitable for resource-limited settings?
Yes, the manual is designed to support implementation across diverse healthcare settings, including facilities with limited resources, by offering adaptable frameworks and addressing common contextual barriers.
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- Issuer
- World Health Organization
- Type
- Manual
- Edition
- Interim version
- Status
- Current
- Published
- 2020-05-05
- Scope
- Facility-level implementation of surgical site infection prevention
- Audience
- Healthcare facility managers, infection prevention teams, surgical staff
- Pages
- 135
- Record history
- Created 23 Oct 2026 · updated 23 Oct 2026 · next check Apr 2027
World Health Organization. Implementation manual to support the prevention of surgical site infections at the facility level: turning recommendations into practice. Geneva: World Health Organization; 2020.GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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