Implementación de las recomendaciones para la prevención de infección de localización quirúrgica en España: encuesta para evaluación de discrepancias con la práctica clínica en cirugía cardiovascular

Abstract

IntroductionA panel constituted by experts from various surgical scientific societies have expressed their concern on the lack of knowledge of the implementation of evidence-based recommendations as regards surgical site infection (SSI) prevention in different surgical specialties in Spain. MethodsThis expert panel designed an on-line questionnaire (SurveyMonkey©) consisting of 59 general questions for any surgical specialty, plus 5 more specific questions for Cardiac Surgery. ResultsThe questionnaire was completed by 82 cardiovascular surgeons from all over Spain, equally distributed into 1-10 years of experience (43%), 11-20 years (27%), and>20 years (30%). There was a high level of knowledge of specific protocols for patient surgical preparation (99%), patient safety in the operating room (87%), and contact isolation (96%). The results showed a lack of agreement between daily clinical practice and evidence-based recommendations in 4 strong recommendations of the World Health Organisation: screening/treatment of methicillin-resistant Staphylococcus aureus, hair removal, type/use of skin antiseptics, and duration of antibiotic prophylaxis. There were differences in another 4 conditional recommendations: preoperative nutritional status assessment, intraoperative glycaemic control, prophylactic use of negative pressure therapies, and antibiotic coated sutures. ConclusionSeveral important improvement areas have been detected towards SSI prevention in Cardiovascular Surgery in Spain, as there are important differences between daily clinical practice and evidence-based recommendations for surgical site infection prevention.