Table 2 Summary of frequency and percentages of the surgeons’ practice of the preventive intra-operative measures of SSI
Measure | n (%) (Total = 281) | WHO Recommendation | Strengtha | Quality of Evidenceb |
|---|---|---|---|---|
Surgical antibiotic prophylaxis | 271 (96.7) | The panel recommends the administration of SAP within 120 min before incision, while considering the half-life of the antibiotic. | Strong | Moderate |
At time of incision | 125 (44.5) | |||
Within 2 h pre-incision | 116 (41.3) | |||
Both | 30 (10.7) | |||
Hair removal by shaving | 75 (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. | Strong | Moderate |
By the patient | 72 (25.6) | |||
By the surgeon | 3 (1.1) | |||
Skin preparation by alcohol-based antiseptic solutions based on CHG | 234 (83.3) | The panel recommends alcohol-based antiseptic solutions based on CHG for surgical site skin preparation in patients undergoing surgical procedures. | Strong | Low to moderate |
Hand preparation | 281 (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. | Strong | Moderate |
Maintaining normothermia | 70 (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. | Conditional | Moderate |
Giving 80% FiO2 | 156 (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. | Strong | Moderate |
Irrigation of incision with povidone-iodine before closure | 111 (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. | Conditional | Low |
Gloving | 106 (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. | NA | NA |
Double-gloving | 91 (32.4) | |||
Change of gloves | 9 (3.2) | |||
Both | 6 (2.1) | |||
Change of surgical instruments | 5 (1.8) | The panel decided not to formulate a recommendation on this topic due to the lack of evidence. | NA | NA |