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AAOS Prevention of Surgical Site Infections After Major Extremity Trauma

Published ,

Appropriate Use Criteria


The purpose of this AUC is to help determine the appropriateness of clinical practice guideline recommendations for the heterogeneous patient population routinely seen in practice. The best available scientific evidence is synthesized with collective expert opinion on topics where gold standard randomized clinical trials are not available or are inadequately detailed for identifying distinct patient types. When there is evidence corroborated by consensus that expected benefits substantially outweigh potential risks, exclusive of cost, a procedure is determined to be appropriate. The AAOS uses the RAND/UCLA Appropriateness Method (RAM)1 to assess the appropriateness of a particular treatment. This process includes reviewing the results of the evidence analysis, compiling a list of clinical vignettes, and having an expert panel comprised of representatives from multiple medical specialties to determine the appropriateness of each of the clinical indications for treatment as “Appropriate,” “May be Appropriate,” or “Rarely Appropriate.” To access a more user-friendly version of the appropriate use criteria for this topic online, please visit our AUC web-based application at the American Academy of Orthopaedis Surgeons 

To view the full version, please visit the Appropriate Use Criteria Document.



This Clinical Practice Guideline (CPG) is one of six funded by a Department of Defense grant to the METRC collaborative to evaluate the evidence regarding various aspects of recovery from injury to determine the most helpful recommendations for treatment. The CPG herein is based on a systematic review of published studies examining the prevention of surgical site infection (SSI) after major extremity trauma in adults. It provides recommendations that will help practitioners to integrate the current evidence and clinical practice, and it highlights gaps in the literature in need of future research. This guideline is intended to be used by appropriately trained physicians and clinicians who manage the treatment of major extremity trauma. It also serves as an information resource for developers and applied users of clinical practice guidelines.

To view the full version of the guideline, please visit the Prevention of Surgical Site Infections After Major Extremity Trauma Evidence-Based Clinical Practice Guideline.

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