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

被引:8
|
作者
Badia, Josep M. [1 ,2 ]
Casey, Anna L. [3 ]
Rubio-Perez, Ines [4 ]
Arroyo-Garcia, Nares [1 ]
Espin, Eloy [5 ]
Biondo, Sebastiano [6 ,8 ]
Balibrea, Jose M. [7 ,8 ]
机构
[1] Hosp Gen Granollers, Dept Surg, Barcelona, Spain
[2] Univ Int Catalunya, Barcelona, Spain
[3] Univ Hosp Birmingham NHS Fdn Trust, Dept Clin Microbiol, Birmingham, W Midlands, England
[4] Hosp Univ La Paz, Dept Surg, Madrid, Spain
[5] Hosp Univ Vall dHebron, Dept Surg, Barcelona, Spain
[6] LHosp Llobregat, Dept Surg, Hosp Univ Bellvitge, Barcelona, Spain
[7] Hosp Clin Barcelona, Dept Surg, Barcelona, Spain
[8] Univ Barcelona, Barcelona, Spain
关键词
colorectal surgery; mechanical bowel preparation; oral antibiotic prophylaxis; prevention; surgical site infection; MECHANICAL BOWEL PREPARATION; ANTIBIOTIC-PROPHYLAXIS; IDENTIFY;
D O I
10.1089/sur.2019.203
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
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.
引用
收藏
页码:218 / 226
页数:9
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