Skip to main content

Table 2 Summary of frequency and percentages of the surgeons’ practice of the preventive intra-operative measures of SSI

From: Determinants of surgeons’ adherence to preventive intraoperative measures of surgical site infection in Gaza Strip hospitals: a multi-centre cross-sectional study

Measuren (%) (Total = 281)WHO RecommendationStrengthaQuality of Evidenceb
Surgical antibiotic prophylaxis271 (96.7)The panel recommends the administration of SAP within 120 min before incision, while considering the half-life of the antibiotic.StrongModerate
 At time of incision125 (44.5)
 Within 2 h pre-incision116 (41.3)
 Both30 (10.7)
Hair removal by shaving75 (26.7)The panel recommends that in patients undergoing any surgical procedure, hair should either not be removed or, if absolutely necessary, it should be removed only with a clipper. Shaving is strongly discouraged at all times, whether preoperatively or in the OR.StrongModerate
 By the patient72 (25.6)
 By the surgeon3 (1.1)
Skin preparation by alcohol-based antiseptic solutions based on CHG234 (83.3)The panel recommends alcohol-based antiseptic solutions based on CHG for surgical site skin preparation in patients undergoing surgical procedures.StrongLow to moderate
Hand preparation281 (100.0)The panel recommends that surgical hand preparation should be performed by scrubbing with either a suitable antimicrobial soap and water or usng a suitable alcohol-based handrub before donning sterile gloves.StrongModerate
Maintaining normothermia70 (24.9)The panel suggests the use of warming devices in the OR and during the surgical procedure for patient body warming with the purpose of reducing SSI.ConditionalModerate
Giving 80% FiO2156 (55.5)The panel recommends that adult patients undergoing general anaesthesia with endotracheal intubation for surgical procedures should receive an 80% fraction of inspired oxygen intraoperatively.StrongModerate
Irrigation of incision with povidone-iodine before closure111 (39.5)The panel suggests considering the use of irrigation of the incisional wound with an aqueous PVP-I solution before closure for the purpose of preventing SSI, particularly in clean and clean-contaminated wounds.ConditionalLow
Gloving106 (37.7)The panel decided not to formulate a recommendation due to the lack of evidence to assess whether double-gloving or a change of gloves during the operation or the use of specific types of gloves are more effective in reducing the risk of SSI.NANA
 Double-gloving91 (32.4)
 Change of gloves9 (3.2)
 Both6 (2.1)
Change of surgical instruments5 (1.8)The panel decided not to formulate a recommendation on this topic due to the lack of evidence.NANA
  1. n number of patients tested, WHO World Health Organization, SAP surgical antibiotic prophylaxis, OR operating room, CHG chlorhexidine gluconate, SSI surgical site infection, FiO2 fraction of inspired oxygen, PVP-I povidone-iodine, NA not applicable
  2. a, bbased on the WHO guidelines