Knowledge Gaps in Evidence-Based Extravasation Management: A Cross-Sectional Survey of Surgical Specialists in Türkiye

Background/Objectives: Severe extravasation injuries require prompt, agent-specific intervention to prevent avoidable tissue loss, yet they are often first assessed by surgeons with no structured training in their management. This study aimed to identify knowledge gaps in evidence-based extravasation management and to determine whether seniority, formal training or institutional factors are associated with a higher knowledge score. Methods: A cross-sectional web-based survey was conducted in June 2026 among orthopedic and plastic surgeons in Türkiye. In total, 359 eligible physicians responded to a 17-item knowledge instrument covering definitions, severity grading, treatment decisions and risk factors, alongside items on demographics, training and institutional infrastructure. Scores were dichotomized at 70% correct to define a high knowledge level, and logistic regression identified independent predictors. Results: The mean knowledge score was 10.0 ± 3.5 of 17 (KR-20 = 0.795), and 127 of 359 participants (35.4%) reached the high-knowledge threshold. Deficiencies were not uniformly distributed: accuracy was high for basic definitional items (76–90%) but markedly lower for time-sensitive therapeutic decisions, including antidote selection and flush-technique indications (51–59%), and for recognition of high-risk agents (24.0%). No independent association was detected between knowledge level and professional seniority, formal training or institution type. More frequent case exposure was associated with a higher mean score in unadjusted analysis (p = 0.017) but was not retained after adjustment. Conclusions: Substantial knowledge gaps were identified across surgical specialties, concentrated in the time-sensitive decisions in which errors may contribute to preventable tissue loss. No independent association was detected between knowledge level and either seniority or formal training; experiential learning alone may therefore not ensure familiarity with current evidence-based management. Standardized cross-specialty education and institutional protocols are needed.