Delphi Consensus on Intraoperative Technical/Surgical Aspects to Prevent Surgical Site Infection after Colorectal...

Area of Science:

• Surgical Innovation
• Infection Control
• Colorectal Surgery

Background:

• Existing research on surgical site infection (SSI) prevention in colorectal surgery (CRS) primarily focuses on perioperative care bundles.
• A gap exists in understanding the specific intraoperative technical and surgical factors influencing SSI risk during CRS.
• This study addresses the need for expert consensus on intraoperative SSI prevention strategies in CRS.

Purpose of the Study:

• To establish an expert consensus on intraoperative technical and surgical aspects of SSI prevention.
• To provide evidence-based recommendations for surgical teams performing colorectal surgery.

Main Methods:

• A modified Delphi process involving 15 colorectal surgeons was employed.
• Consensus was built over up to three rounds, utilizing literature review and expert opinion.
• A ≥70% agreement threshold was used to define consensus on each topic.

Main Results:

• The expert panel achieved consensus on 16 evidence-based statements regarding intraoperative SSI prevention.
• Recommended interventions include wound protectors, sterile closure trays, preclosure glove changes, and antimicrobial sutures.
• For high-risk, contaminated wounds, consensus supported wound irrigation with aqueous iodine and negative pressure wound therapy.

Conclusions:

• A consensus has been established on specific technical/surgical recommendations for SSI reduction during CRS.
• These recommendations address areas with controversial or limited evidence.
• The findings provide a foundation for future research and the integration of new technologies in CRS.