Josep M Badia1, Anna L Casey2, Inés Rubio-Pérez3, Cynthia Crosby4, Nares Arroyo-García5, José M Balibrea6. 1. Department of Surgery, Hospital General de Granollers, Universitat Internacional de Catalunya, Spanish Association of Surgeons, Barcelona, Spain. Electronic address: jmbadia@fhag.es. 2. Clinical Research Scientist, Department of Clinical Microbiology, University Hospitals Birmingham NHS Foundation Trust, UK. 3. Department of Surgery, Hospital Universitario la Paz, Madrid, Spain. 4. Becton Dickinson & Co., Franklin Lakes, NJ, USA. 5. Department of Surgery, Hospital General de Granollers, Barcelona, Spain. 6. Department of Surgery, Hospital Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona, Spanish Association of Surgeons, Barcelona, Spain.
Abstract
BACKGROUND: The knowledge of the grade of implementation of preventative measures for surgical site infection (SSI) is crucial prior to planning dissemination strategies. METHODS: Online survey among the members of the Spanish Association of Surgeons (AEC) to know the actual application of measures, and to compare them with new recommendations issued by international organizations. RESULTS: Most of the 835 responding surgeons work in National Health Service Hospitals (91.3%). Surgeons of all super-specialties answered. 90.4% of responders recommend a preoperative shower, with normal soap or chlorhexidine. 60% recommend hair removal, preferably clipping, although 30% still recommend shaving. Povidone-iodine in aqueous solution or chlorhexidine in alcohol are used for skin preparation. Only 51.9% of surgeons allow solution to air drying before applying surgical drapes. In 83.2% of cases surgeons operate with a single pair of gloves. Perioperative normothermia and hyperoxia were used in 92% and 27.9% of cases, respectively. At the end of the procedure, peritoneal and wound lavage are used, in most cases with saline. Antimicrobial impregnated sutures are rarely used (85.7%) by surgeons, and 32% occasionally use negative pressure therapy on the closed wound. CONCLUSIONS: There is great variability in the level of awareness and application of the main measures of SSI prevention among Spanish surgeons. Several areas for improvement have been detected, as core prevention measures are not in common use, and discontinued practices are continued to be used. These practices should be addressed by the AEC by drafting specific recommendations for the prevention of SSI in Spanish hospitals.
BACKGROUND: The knowledge of the grade of implementation of preventative measures for surgical site infection (SSI) is crucial prior to planning dissemination strategies. METHODS: Online survey among the members of the Spanish Association of Surgeons (AEC) to know the actual application of measures, and to compare them with new recommendations issued by international organizations. RESULTS: Most of the 835 responding surgeons work in National Health Service Hospitals (91.3%). Surgeons of all super-specialties answered. 90.4% of responders recommend a preoperative shower, with normal soap or chlorhexidine. 60% recommend hair removal, preferably clipping, although 30% still recommend shaving. Povidone-iodine in aqueous solution or chlorhexidine in alcohol are used for skin preparation. Only 51.9% of surgeons allow solution to air drying before applying surgical drapes. In 83.2% of cases surgeons operate with a single pair of gloves. Perioperative normothermia and hyperoxia were used in 92% and 27.9% of cases, respectively. At the end of the procedure, peritoneal and wound lavage are used, in most cases with saline. Antimicrobial impregnated sutures are rarely used (85.7%) by surgeons, and 32% occasionally use negative pressure therapy on the closed wound. CONCLUSIONS: There is great variability in the level of awareness and application of the main measures of SSI prevention among Spanish surgeons. Several areas for improvement have been detected, as core prevention measures are not in common use, and discontinued practices are continued to be used. These practices should be addressed by the AEC by drafting specific recommendations for the prevention of SSI in Spanish hospitals.
Authors: Massimo Sartelli; Yoram Kluger; Luca Ansaloni; Federico Coccolini; Gian Luca Baiocchi; Timothy C Hardcastle; Ernest E Moore; Addison K May; Kamal M F Itani; Donald E Fry; Marja A Boermeester; Xavier Guirao; Lena Napolitano; Robert G Sawyer; Kemal Rasa; Fikri M Abu-Zidan; Abdulrashid K Adesunkanmi; Boyko Atanasov; Goran Augustin; Miklosh Bala; Miguel A Cainzos; Alain Chichom-Mefire; Francesco Cortese; Dimitris Damaskos; Samir Delibegovic; Zaza Demetrashvili; Belinda De Simone; Therese M Duane; Wagih Ghnnam; George Gkiokas; Carlos A Gomes; Andreas Hecker; Aleksandar Karamarkovic; Jakub Kenig; Vladimir Khokha; Victor Kong; Arda Isik; Ari Leppäniemi; Andrey Litvin; Eftychios Lostoridis; Gustavo M Machain; Sanjay Marwah; Michael McFarlane; Cristian Mesina; Ionut Negoi; Iyiade Olaoye; Tadeja Pintar; Guntars Pupelis; Miran Rems; Ines Rubio-Perez; Boris Sakakushev; Helmut Segovia-Lohse; Boonying Siribumrungwong; Peep Talving; Jan Ulrych; András G Vereczkei; Francesco M Labricciosa; Fausto Catena Journal: World J Emerg Surg Date: 2018-08-17 Impact factor: 5.469