Implementation of surgical site infection prophylaxis in children - a cross-sectional prospective study

C Paganetti¹, U Subotic¹, C Sanchez², C Deak³, R Kusche³, G Autorino⁴, M Mendoza-Sagaon⁴, V A Pfeifle⁵, R Gualtieri⁶, K Posfay-Barbe⁶, R Oppenheim⁷, N Jauquier⁷, M Lehner⁸, M Buettcher⁹, J Männer¹⁰, A Beccarelli¹¹, K Meier¹¹, J A Bielicki¹², I N Bielicki¹³

Affiliations

¹ Department of Paediatric Surgery, University of Basel Children's Hospital, Basel, Switzerland.
² Paediatric Research Centre, University of Basel Children's Hospital, Basel, Switzerland.
³ Department of General Paediatrics, Children's Hospital Aarau KSA, Aarau, Switzerland.
⁴ Department of Paediatric Surgery, Institute of Paediatrics of Southern Switzerland, Bellinzona, Switzerland.
⁵ Department of Paediatric Surgery, University Hospital, Inselspital Bern, Bern, Switzerland.
⁶ Paediatric Platform for Clinical Research, Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland.
⁷ Département femme-mère-enfant, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Lausanne, Switzerland.
⁸ Department of Paediatric Surgery, Children's Hospital of Central Switzerland, Lucerne, Switzerland.
⁹ Paediatric Infectious Diseases Unit, Department of Paediatrics, Children's Hospital of Central Switzerland, Lucerne, Switzerland; Paediatric Pharmacology and Pharmacometrics Research Centre, University Children's Hospital Basel, Basel, Switzerland; Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
¹⁰ Department of Infectious Diseases and Hospital Epidemiology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland; Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.
¹¹ Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
¹² Paediatric Research Centre, University of Basel Children's Hospital, Basel, Switzerland; Department of Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland; Centre for Neonatal and Paediatric Infection, City St George's, University of London, London, UK.
¹³ Department of Paediatric Surgery, University of Basel Children's Hospital, Basel, Switzerland. Electronic address: isabella.bielicki@ukbb.ch.

PMID: 40339919
DOI: 10.1016/j.jhin.2025.03.018

Free article

Implementation of surgical site infection prophylaxis in children - a cross-sectional prospective study

C Paganetti et al. J Hosp Infect. 2025 Aug.

Free article

. 2025 Aug:162:360-367.

doi: 10.1016/j.jhin.2025.03.018. Epub 2025 May 6.

Authors

Affiliations

¹ Department of Paediatric Surgery, University of Basel Children's Hospital, Basel, Switzerland.
² Paediatric Research Centre, University of Basel Children's Hospital, Basel, Switzerland.
³ Department of General Paediatrics, Children's Hospital Aarau KSA, Aarau, Switzerland.
⁴ Department of Paediatric Surgery, Institute of Paediatrics of Southern Switzerland, Bellinzona, Switzerland.
⁵ Department of Paediatric Surgery, University Hospital, Inselspital Bern, Bern, Switzerland.
⁶ Paediatric Platform for Clinical Research, Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland.
⁷ Département femme-mère-enfant, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Lausanne, Switzerland.
⁸ Department of Paediatric Surgery, Children's Hospital of Central Switzerland, Lucerne, Switzerland.
⁹ Paediatric Infectious Diseases Unit, Department of Paediatrics, Children's Hospital of Central Switzerland, Lucerne, Switzerland; Paediatric Pharmacology and Pharmacometrics Research Centre, University Children's Hospital Basel, Basel, Switzerland; Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
¹⁰ Department of Infectious Diseases and Hospital Epidemiology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland; Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.
¹¹ Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
¹² Paediatric Research Centre, University of Basel Children's Hospital, Basel, Switzerland; Department of Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland; Centre for Neonatal and Paediatric Infection, City St George's, University of London, London, UK.
¹³ Department of Paediatric Surgery, University of Basel Children's Hospital, Basel, Switzerland. Electronic address: isabella.bielicki@ukbb.ch.

PMID: 40339919
DOI: 10.1016/j.jhin.2025.03.018

Abstract

Background: Surgical site infections (SSIs) are a common cause of morbidity and mortality in both adults and children. In paediatric surgery, evidence on specific prevention measures is lacking, and practices mainly depend on local guidelines and the preferences of the treating team.

Aim: To investigate current practices for children undergoing surgery with respect to SSI prevention using a standardized surveillance tool.

Methods: Nine Swiss paediatric surgery centres participated in a standard period prevalence study. SSI prevention measures were recorded in these hospitals over 7 consecutive days in October 2022 for any paediatric surgical procedure resulting in a surgical wound. The SSI prevention measures of interest were drawn from the most recent World Health Organization guidelines.

Findings: In total, 351 procedures were included. All Swiss language regions were represented. Traumatologic/orthopaedic surgeries were most common. Surgical antibiotic prophylaxis was administered in 161/351 (46%) cases, although in 33/161 (21%) cases, there was no indication for the administration of antibiotics. Alcohol-based or iodine-based solutions were most often used for surgical skin preparation. Antimicrobial-coated sutures were only used in 84/351 (24%) cases. Regional differences in prevention measures were noted between participating centres for skin preparation solution, suture material, wound dressing, and implementation of warming devices.

Conclusion: This study provides an overview of current SSI prevention practices in Swiss paediatric surgery centres, identifies targets for improvement, and highlights areas of clinical uncertainty requiring further investigation. The findings underscore the need for standardized guidelines to ensure consistent and evidence-based SSI prevention strategies in paediatric surgery.

Keywords: Infection control/methods; Paediatric surgery; Surgical wound infection/prevention and control; Switzerland.

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Conflict of interest statement

Conflict of interest statement None declared.

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Implementation of surgical site infection prophylaxis in children - a cross-sectional prospective study

Affiliations

Implementation of surgical site infection prophylaxis in children - a cross-sectional prospective study

Authors

Affiliations

Abstract

Conflict of interest statement

MeSH terms

LinkOut - more resources

Full Text Sources