Implementation of the recommendations for prevention of surgical site infection in Spain: A survey to evaluate the gap between evidence-based recommendations and daily clinical practice in cardiovascular surgery

Introduction: A panel constituted by experts from various surgical scientific societies have expressed their concern on the lack of knowledge of the implementation of evidence-based recommendations as regards surgical site infection (SSI) prevention in different surgical specialties in Spain. Methods: This expert panel designed an on-line questionnaire (SurveyMonkey (c)) consisting of 59 general questions for any surgical specialty, plus 5 more specific questions for Cardiac Surgery. Results: The questionnaire was completed by 82 cardiovascular surgeons from all over Spain, equally distributed into 1-10 years of experience (43%), 11-20 years (27%), and >20 years (30%). There was a high level of knowledge of specific protocols for patient surgical preparation (99%), patient safety in the operating room (87%), and contact isolation (96%). The results showed a lack of agreement between daily clinical practice and evidence-based recommendations in 4 strong recommendations of the World Health Organisation: screening/treatment of methicillin-resistant Staphylococcus aureus, hair removal, type/use of skin antiseptics, and duration of antibiotic prophylaxis. There were differences in another 4 conditional recommendations: preoperative nutritional status assessment, intraoperative glycaemic control, prophylactic use of negative pressure therapies, and antibiotic coated sutures. Conclusion: Several important improvement areas have been detected towards SSI prevention in Cardiovascular Surgery in Spain, as there are important differences between daily clinical practice and evidence-based recommendations for surgical site infection prevention. (C) 2019 Sociedal Espanola de Cirugia Torkica-Cardiovascular. Published by Elsevier Espana, S.L.U.