Impact of enhanced recovery after surgery (ERAS) on surgical site infections in pediatric surgery

Enhanced recovery after surgery (ERAS) is a multidisciplinary, evidence-based protocol designed to standardize perioperative care, minimize complications, and optimize recovery. While ERAS has demonstrated significant benefits in adult populations, widespread adoption in pediatric surgery remains in progress. One of its central goals is reducing postoperative infections, particularly surgical site infections (SSIs), which represent a common source of morbidity in children. Core ERAS elements-including perioperative nutrition, glycemic control, fluid and temperature management, antibiotic prophylaxis, wound care, device removal, and early mobilization-directly or indirectly influence infection risk. Although pediatric-specific data remain limited, growing evidence supports that ERAS protocols are safe and may reduce SSI incidence. This narrative review outlines how individual ERAS components target SSI prevention, highlights current pediatric evidence, and identifies knowledge gaps where further research is needed to optimize infection prevention strategies for children undergoing surgery.