PRESS survey: PREvention of surgical site infection-a global pan-specialty survey of practice protocol

J Heinz; J Walshaw; J Y Kwan; J Long; D Carradice; J Totty; K M Kontouli; P Lainas; L Hitchman; G Smith; B Huo; H Guadalajara; D Garcia-Olmo; D Sharma; C S Biyani; J Tomlinson; M Loubani; R Galli; R Lathan; I Chetter; M Yiasemidou

doi:10.3389/fsurg.2023.1251444

PRESS survey: PREvention of surgical site infection-a global pan-specialty survey of practice protocol

Front Surg. 2023 Sep 25:10:1251444. doi: 10.3389/fsurg.2023.1251444. eCollection 2023.

Authors

J Heinz^{1

2}, J Walshaw^{1

2

3}, J Y Kwan⁴, J Long^{1

2}, D Carradice^{1

2}, J Totty^{1

5}, K M Kontouli⁶, P Lainas^{7

8}, L Hitchman^{1

2}, G Smith^{1

2}, B Huo⁹, H Guadalajara¹⁰, D Garcia-Olmo¹⁰, D Sharma¹¹, C S Biyani¹², J Tomlinson¹³, M Loubani¹⁴, R Galli¹⁵, R Lathan^{1

2

3}, I Chetter^{1

2}, M Yiasemidou^{1

16}

Affiliations

¹ Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom.
² Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom.
³ Department of Health Sciences, University of York, York, United Kingdom.
⁴ Leeds Vascular Institute, Leeds Teachings Hospitals NHS Trust, Leeds, United Kingdom.
⁵ Department of Plastic and Reconstructive Surgery, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom.
⁶ Department of Mathematics, University of Ioannina, Ioannina, Greece.
⁷ Department of Digestive Surgery, Metropolitan Hospital, HEAL Academy, Athens, Greece.
⁸ Department of Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, Partis-Saclay University, Clamart, France.
⁹ Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
¹⁰ Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain.
¹¹ Department of Surgery, Government NSCB Medical College, Jabalpur, India.
¹² Department of Urology, St James University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
¹³ Trauma and Orthopedics, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
¹⁴ Department of Cardiothoracic Surgery, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom.
¹⁵ Department of Surgery, Cantonal Hospital Baselland, Liestal, Switzerland.
¹⁶ Department of General Surgery, Bradford Teaching Hospitals NHS Trust, Bradford, United Kingdom.

Abstract

Background: Surgical site infections (SSI) complicate up to 40% of surgical procedures, leading to increased patient morbidity and mortality. Previous research identified disparities in SSI prevention guidelines and clinical practices across different institutions. The study aims to identify variations in SSI prevention practices within and between specialties and financial systems and provide a representation of existing SSI preventative measures to help improve the standardization of SSI prevention practices.

Methods: This collaborative cross-sectional survey will be aimed at pan-surgical specialties internationally. The study has been designed and will be reported in line with the CROSS and CHERRIES standards. An international study steering committee will design and internally validate the survey in multiple consensus-based rounds. This will be based on SSI prevention measures outlined in the CDC (2017), WHO (2018), NICE (2019), Wounds UK (2020) and the International Surgical Wound Complications Advisory Panel (ISWCAP) guidelines. The questionnaire will include demographics, SSI surveillance, preoperative, peri-operative and postoperative SSI prevention. Data will be collected on participants' surgical specialty, operative grade, of practice and financial healthcare system of practice. The online survey will be designed and disseminated using Qualtrics^XM Platform™ through national and international surgical colleges and societies, in addition to social media and snowballing. Data collection will be open for 3 months with reminders, and raking will be used to ascertain the sample. Responses will be analyzed, and the chi-square test used to evaluate the impact of SSI prevention variables on responses.

Discussion: Current SSI prevention practice in UK Vascular surgery varies considerably, with little consensus on many measures. Given the inconsistency in guidelines on how to prevent SSIs, there is a need for standardization. This survey will investigate the disparity in SSI preventative measures between different surgical fields and countries.

Keywords: guidelines; practice; surgery; surgical wound infection; survey.

Grants and funding

The sponsor of the study is Hull University Teaching Hospitals NHS Trust, R&D Department, Office 13, 2nd Floor Daisy Building, Castle Hill Hospital, Castle Road, Cottingham, East Yorkshire, HU15 JQ. The study is funded by the Vascular and Endovascular Research Network.