Awareness of Practice and Comparison with Best Evidence in Surgical Site Infection Prevention in Colorectal Surgery

Abstract

Background: The use of mechanical bowel preparation and prophylaxis with oral antimicrobial agents can prevent surgical site infection (SSI) in colorectal surgical procedures, but routine adoption of these and other practices by surgeons has been limited. The aim of this study was to determine the actual practice and surgeon beliefs about preventative measures in elective colorectal operations and to compare them with established recommendations. Methods: Web-based survey was sent to colorectal surgeons assessing knowledge, beliefs, and practices regarding the use of preventative measures for SSI. Results: Of 355 surgeons, 33% had no feedback of SSI rate; 60% believed in evidence for normothermia, wound edge protection, and use of alcohol solution, and reported use of these strategies. There was a discrepancy in the assumed evidence and use of hyperoxia, glove replacement after anastomosis, surgical tools replacement, and saline surgical site lavage. Most of respondents believe that oral antibiotic prophylaxis diminishes infection, but is indicated only by one third of them. Few surgeons believe in MBP, but many actually use it. Most surgeons believe that there is a discrepancy between published guidelines and actual clinical practice. As proper means to implement guidelines, checklists, standardized orders, surveillance, feedback of SSI rates, and educational programs are rated most highly by surgeons, but few of these are in place at their institutions. Conclusions: Gaps in the translation of evidence into practice remain in the prevention of SSI in colorectal surgical procedures. Several areas for improvement have been identified. Specific implementation strategies should be addressed in colorectal units.

Preoperatif cilt antisepsisi için 2 farklı rejimin cerrahi alan enfeksiyon sonuçları: povidon-iyot ile tek katmana karşı povidon-iyot / oktenidin dihidroklorür ile çift katman

“…Despite these huge amounts of several different studies, many centers seemed to stay conservative and conformist, which may be failed to enhance the optimal level of skin preparation [9][10][11]. Our study demonstrated not only the different techniques of skin antisepsis but also a very significant attempt to digress the comfort zone of conventional disinfection techniques.…”

Mechanical bowel preparation and antibiotics in elective colorectal surgery: network meta-analysis

“…Historically, mechanical cleansing was thought to be among the most important factors influencing outcomes in colorectal surgery 105 . Today, the use of preoperative MBP is still commonly practiced 100 , 106 , 107 and widely recommended 35 . The current study found no clear advantage from the addition of MBP, which contrasts with results of several previous studies, including previous large retrospective cohort studies of the ACS NSQIP colectomy database 31–33 , 108 , which favoured combined MBP + OAB.…”

Knowledge and Awareness about Wound Infection after Surgery among Population in Saudi Arabia

“…The prevalence of Health careassociated infections (HCAIs) was 7.59 percent and 14.5% of this infection was associated with SSIs in study done among 75,694 patients in Republic of Ireland, England, Wales and Northern Ireland, SSIs are among the most preventable HCAIs, according to the World Health Organization and the Centers for Disease Control and Prevention (CDC) [5]. In Europe SSIs prevalence 21.6% that's mean SSIs become now the most common hospital-acquired infection [6]. In 2017, research has been conducted on reducing surgical site infection with negative therapy and the result has shown 71 patients, comprising 33 in an Experimental Group and 38 in the Control Group, were included in this study between May 2014 and December 2015.…”