[Western guidelines on the prevention of postoperative infections and compliance]

Postoperative infections should be comprehensively controlled in the context of infection control, rather than as activities of individual surgeons. More Japanese surgeons have recently become interested in infection control but not many studies have been done in this field in Japan. As a result, surgeons are dependent on guidelines published abroad, especially in the USA and Europe. These guidelines are generally evidence based and applicable to the Japanese medical system. However, some recommendations such as antimicrobial prophylaxis are controversial, and evidence from surgery on specific organs is lacking. This results in difficulty in accepting the guidelines by Japanese surgeons, as well as poor compliance by US surgeons. Furthermore, Japanese surgeons operate mainly on Japanese patients and perform invasive operations involving the hepatobiliary system and esophagus more frequently than Western surgeons. Evidence for infection control during and after such operations should be obtained through randomized, controlled trials performed in Japan.