SP1.4 - PRESS survey: PREvention of surgical site infection—a global pan-specialty survey of prophylactic practices

Abstract Aims This survey aimed to establish current global practice across surgical subspecialties in the prevention of surgical site infection (SSI) using prophylactic measures. Methodology A cross-sectional survey was formulated following a published protocol, aligning with established guidelines for SSI prevention. A panel of experts provided guidance during iterative rounds of internal validation, incorporating consensus-based modifications. Prior to online dissemination via QualtricsXM link and QR code through international surgical societies, the survey underwent external validation. Recruitment strategies were through international societies, snowballing and social media. Results There were 1232 responses from 97 countries, with 698(56.7%) participants completing all inquiries. Responses were primarily provided by consultants or equivalent (766,75.2%), spanning all ten Royal College of Surgeons-recognised subspecialties. Almost all surgeons (734/779,94.2%) give pre-operative antibiotic prophylaxis at or within one hour of incision. Nutritional assessments do not routinely occur, with less than half (314/734,42.8%) performed often or always. Intraoperatively, normothermia is often or always maintained with standard blankets (389/734,53.0%) and forced air warming (435/734,59.3%) and less frequently with warmed fluids (277/734,37.7%) and heated mattresses (176/734,24.0%). Most surgeons (615/734,83.8%) would use non-iodinated drapes, whereas iodinated are used less frequently (472/734,64.3%). Triclosan coated sutures are never used by almost half of all surgeons (365/734,49.7%). Most surgeons (528/734,71.9%) use a simple wound dressing after skin closure. Conclusions Most prophylactic measures for SSI prevention display considerable variation in practice. Surgeons agree upon pre-operative antibiotic timing, in line with strong evidence and guidance. Other measures, such as antimicrobial sutures which have strong NICE recommendations, are used invariably.