SP1.5 - PRESS survey: PREvention of surgical site infection—a global pan-specialty survey of practice

Abstract Aims This survey aimed to establish current global practice across surgical subspecialties in the prevention of surgical site infection (SSI). Methodology A cross-sectional survey was formulated following a published protocol, aligning with established global 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 final external validation. Recruitment strategies were through international societies, snowballing and social media. Findings 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. A significant majority (786/889,88.4%) routinely employs clinical examination for SSI diagnosis, while one-third (305/889,34.3%) never use the CDC criteria. Regarding surgical field preparation, less than half regularly use alcoholic povidone-iodine (339/778,43.6%) or chlorhexidine gluconate (370/778,47.6%). However, approximately one-third often or always use aqueous (478/1556,30.7%) or alcoholic (454/1556,29.2%) solutions for hand scrub. Surgeons exhibit a higher likelihood of changing gloves (614/734,83.7%) than instruments (513/734,69.9%) to facilitate clean skin closure. Most UK surgeons (181/206,87.9%) express equipoise in randomising patients for interventions in a potential platform trial evaluating SSI prevention. Conclusions Significant diversity characterizes global and subspecialty-specific practices in various SSI prevention measures, attributable to conflicting guidance and limited evidentiary support for recommendations. Encouragingly, a substantial number of surgeons express readiness to contribute to a robust evidence base through participation in potential platform trials for SSI prevention.