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. 2021 Aug;73(4):1315-1325.
doi: 10.1007/s13304-021-01029-z. Epub 2021 Mar 26.

Management of superficial and deep surgical site infection: an international multidisciplinary consensus

Gabriele Sganga  1 , Mohamed Baguneid  2   3   4 , Pascal Dohmen  5   6 , Evangelos J Giamarellos-Bourboulis  7 , Emilio Romanini  8 , Athanassios Vozikis  9 , Christian Eckmann  10
Affiliations

Management of superficial and deep surgical site infection: an international multidisciplinary consensus

Gabriele Sganga et al. Updates Surg. 2021 Aug.

Abstract

Surgical site infections represent a considerable burden for healthcare systems. To obtain a consensus on the impact and future clinical and economic needs regarding SSI management in an era of multidrug resistance. A modified Delphi method was used to obtain consensus among experts from five European countries. The Delphi questionnaire was assembled by a steering committee, verified by a panel of experts and administered to 90 experts in 8 different surgical specialities (Abdominal, Cancer, Cardiac, General surgery, Orthopaedic, Thoracic, Transplant and Vascular and three other specialities (infectious disease, internal medicine microbiology). Respondents (n = 52) reached consensus on 62/73 items including that resistant pathogens are an increasing matter of concern and increase both treatment complexity and the length of hospital stay. There was strong positive consensus on the cost-effectiveness of early discharge (ED) programs, improvement of quality of life with ED and association between increased length of stay and economic burden to the hospital. However, established ED protocols were not widely available in their hospitals. Respondents expressed a positive consensus on the usefulness of antibiotics that allow ED. Surgeons are aware of their responsibility in an interdisciplinary team for the treatment of SSI, and of the impact of multidrug-resistant bacteria in the context of SSI. Reducing the length of hospital stays by applying ED protocols and implementing new treatment alternatives is crucial to reduce harm to patients and costs for the hospital.

Keywords: Antimicrobial; Management; Surgical site infection.

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Conflict of interest statement

Gabriele Sganga, Mohamed Baguneid, Pascal Dohmen, Emilio Romanini and Athanassios Vozikis declare no conflicts of interest. E.J. Giamarellos-Bourboulis has received honoraria from AbbVie USA, Abbott CH, Biotest Germany, Brahms GmbH, InflaRx GmbH, MSD Greece, XBiotech Inc. and Angelini Italy; independent educational grants from AbbVie, Abbott, Astellas Pharma Europe, AxisShield, bioMérieux Inc, InflaRx GmbH, the Medicines Company and XBiotech Inc.; and funding from the FrameWork 7 program HemoSpec (granted to the National and Kapodistrian University of Athens), the Horizon2020 Marie-Curie Project European Sepsis Academy (granted to the National and Kapodistrian University of Athens), and the Horizon 2020 European Grant ImmunoSep (granted to the Hellenic Institute for the Study of Sepsis). Christian Eckmann received honoraria for lectures and advisory boards from Angelini, Correvio, Nabriva, Merck and Pfizer.

Figures

Fig. 1
Fig. 1
Percentage of agreement and number of respondents on each statement of the Delphi questionnaire. Topic 1: Epidemiology
Fig. 2
Fig. 2
Percentage of agreement and number of respondents on each statement of the Delphi questionnaire. Topic 2: Management
Fig. 3
Fig. 3
Percentage of agreement and number of respondents on each statement of the Delphi questionnaire. Topic 3: Consequences
Fig. 4
Fig. 4
Percentage of agreement and number of respondents on each statement of the Delphi questionnaire. Topic 4: Antibiotic therapy approach
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