Adherence to international and national recommendations for the prevention of surgical site infections in Italy: results from an observational prospective study in elective surgery

Am J Infect Control. 2012 Dec;40(10):969-72. doi: 10.1016/j.ajic.2011.11.016. Epub 2012 Mar 13.

Abstract

Background: An observational prospective study of the perioperative procedures for prevention of surgical site infections (SSIs) was carried out in a tertiary referral teaching hospital in Liguria, Italy, to evaluate their adherence to international and national standards.

Methods: A 1-month survey was performed in all surgical departments, monitored by turns by trained survey teams. Data regarding presurgical patient preparation and intraoperative infection control practices were collected.

Results: A total of 717 elective interventions were actively monitored in 703 patients who underwent surgery. Hair-shaving was performed mainly using a razor (92%) by the nurses (72.8%) on the day before the operation (83.5%). All of the patients showered, either with a common detergent (87%) or with an antiseptic solution (13%). Antimicrobial prophylaxis was administered properly in 75.7% of the patients at induction of anaesthesia; however, according to current Italian guidelines, inappropriate prophylaxis was provided in 55.2% patients. Appropriate antisepsis of the incision area was done in 97.4% of the operations, and nearly 90% of the interventions lasted less than the respective 75th percentile. The doors of the operating theatres were mostly open during the duration of the operation in 36.3% of the cases.

Conclusions: This review of infection control policies identified significant opportunities for improving the safety and the quality of routine surgical practice.

MeSH terms

  • Elective Surgical Procedures / adverse effects
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Italy / epidemiology
  • Preoperative Care / methods*
  • Prospective Studies
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / prevention & control*
  • Tertiary Care Centers