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The Practices and Attitudes of Saudi Plastic Surgeons in Managing Contaminated Autologous Grafts
Fahad Aljindan1, Fahad Alhumaid2, Noor H Allababidi3,4
1Plastic Surgery Department, King Abdullah Medical City, Makkah, Saudi Arabia.
Background:
The use of autologous grafts is a standard reconstructive option in plastic surgery. The absence of a well-established protocol for decontamination after accidental contamination increases the risk of postoperative infection. We aimed to explore the current practice and decontamination methods among Saudi plastic surgeons. This would help develop a well-established, unified method of decontamination intraoperatively.
Methods:
A validated self-administered questionnaire cross-sectional study was conducted in February 2022. The questionnaire was distributed through social media to all board-certified plastic surgeons in Saudi Arabia. The questionnaire was designed to obtain data on incidents, treatment preferences, and management of autograft contamination.
Results:
A total sample size of 61 participants was included, with an overall response rate of 64.58%. Out of the 61 respondents, 73.8% (n = 45) had previously experienced graft contamination. Regarding the methods of graft contamination, the most common way was accidentally dropping the graft on the floor (39.7%, n = 25). The majority of the surgeons answered that they decontaminated the graft using povidone-iodine (44.6%, n = 29) and then used it (45.9%, n = 28). The lower extremity area was the most common anatomical location having surgery at the time of the graft contamination, accounting for 32.5% of the cases (n = 25).
Conclusions:
Our study indicates that graft contamination is a common occurrence among our population, but we lack national guidelines on dealing with these situations. Although most responders used adequate decontamination methods, the lack of standardization could pose a risk to patients.
Insights
Autograft contamination is common in Saudi plastic surgery, with many surgeons using povidone-iodine for decontamination. However, a lack of standardized protocols increases patient infection risk.
Area of Science:
- Plastic Surgery
- Surgical Innovation
- Patient Safety
Background:
- Autologous grafts are standard in reconstructive plastic surgery.
- Accidental graft contamination poses a significant risk of postoperative infection.
- A lack of established decontamination protocols hinders intraoperative management.
Purpose of the Study:
- To explore current practices and decontamination methods for autografts among Saudi plastic surgeons.
- To identify the prevalence and common causes of graft contamination.
- To inform the development of a unified decontamination protocol.
Main Methods:
- A cross-sectional study utilizing a validated self-administered questionnaire.
- The survey was distributed via social media to board-certified plastic surgeons in Saudi Arabia.
- Data collected included graft contamination incidents, treatment preferences, and management strategies.
Main Results:
- 61 plastic surgeons participated, with a 64.58% response rate.
- 73.8% of respondents reported prior graft contamination experiences.
- Povidone-iodine was the most common decontamination agent (44.6%), often after dropping the graft (39.7%).
Conclusions:
- Graft contamination is a frequent event in Saudi plastic surgery.
- There is a notable absence of national guidelines for managing graft contamination.
- While methods exist, a lack of standardization presents a potential patient risk.
