TY - JOUR
T1 - Delphi Consensus on Intraoperative Technical/Surgical Aspects to Prevent Surgical Site Infection after Colorectal Surgery
AU - Ruiz-Tovar, Jaime
AU - Boermeester, Marja A.
AU - Bordeianou, Liliana
AU - Chang, George J.
AU - Gorgun, Emre
AU - Justinger, Christoph
AU - Lawson, Elise H.
AU - Leaper, David J.
AU - Mahmoud, Najjia N.
AU - Mantyh, Christopher
AU - McGee, Michael F.
AU - Nfonsam, Valentine
AU - Rubio-Perez, Ines
AU - Wick, Elizabeth C.
AU - Hedrick, Traci L.
N1 - Funding Information:
Disclosure Information: This study was supported by funding from Johnson & Johnson and Ethicon, Inc.
Publisher Copyright:
© 2021 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - BACKGROUND: Previous studies have focused on the development and evaluation of care bundles to reduce the risk of surgical site infection (SSI) throughout the perioperative period. A focused examination of the technical/surgical aspects of SSI reduction during CRS has not been conducted. This study aimed to develop an expert consensus on intraoperative technical/surgical aspects of SSI prevention by the surgical team during colorectal surgery (CRS). STUDY DESIGN: In a modified Delphi process, a panel of 15 colorectal surgeons developed a consensus on intraoperative technical/surgical aspects of SSI prevention undertaken by surgical personnel during CRS using information from a targeted literature review and expert opinion. Consensus was developed with up to three rounds per topic, with a prespecified threshold of ≥70% agreement. RESULTS: In 3 Delphi rounds, the 15 panelists achieved consensus on 16 evidence-based statements. The consensus panel supported the use of wound protectors/retractors, sterile incision closure tray, preclosure glove change, and antimicrobial sutures in reducing SSI along with wound irrigation with aqueous iodine and closed-incision negative pressure wound therapy in high-risk, contaminated wounds. CONCLUSIONS: Using a modified Delphi method, consensus has been achieved on a tailored set of recommendations on technical/surgical aspects that should be considered by surgical personnel during CRS to reduce the risk of SSI, particularly in areas where the evidence base is controversial or lacking. This document forms the basis for ongoing evidence for the topics discussed in this article or new topics based on newly emerging technologies in CRS.
AB - BACKGROUND: Previous studies have focused on the development and evaluation of care bundles to reduce the risk of surgical site infection (SSI) throughout the perioperative period. A focused examination of the technical/surgical aspects of SSI reduction during CRS has not been conducted. This study aimed to develop an expert consensus on intraoperative technical/surgical aspects of SSI prevention by the surgical team during colorectal surgery (CRS). STUDY DESIGN: In a modified Delphi process, a panel of 15 colorectal surgeons developed a consensus on intraoperative technical/surgical aspects of SSI prevention undertaken by surgical personnel during CRS using information from a targeted literature review and expert opinion. Consensus was developed with up to three rounds per topic, with a prespecified threshold of ≥70% agreement. RESULTS: In 3 Delphi rounds, the 15 panelists achieved consensus on 16 evidence-based statements. The consensus panel supported the use of wound protectors/retractors, sterile incision closure tray, preclosure glove change, and antimicrobial sutures in reducing SSI along with wound irrigation with aqueous iodine and closed-incision negative pressure wound therapy in high-risk, contaminated wounds. CONCLUSIONS: Using a modified Delphi method, consensus has been achieved on a tailored set of recommendations on technical/surgical aspects that should be considered by surgical personnel during CRS to reduce the risk of SSI, particularly in areas where the evidence base is controversial or lacking. This document forms the basis for ongoing evidence for the topics discussed in this article or new topics based on newly emerging technologies in CRS.
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U2 - 10.1097/XCS.0000000000000022
DO - 10.1097/XCS.0000000000000022
M3 - Article
C2 - 35213454
AN - SCOPUS:85125548089
SN - 1072-7515
VL - 234
SP - 1
EP - 11
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 1
ER -