Picture of Peri-Operative Antisepsis Practices (PPAP Survey) in France

Abstract Surgical skin preparation is performed according to peri-operative antisepsis protocols. These protocols are based on clinical practice recommendations and may vary from institution to institution. The objective of the survey, conducted among 481 surgeons and 98 scrub nurses of five specialties (cardiac, gastrointestinal, obstetrics and gynecology, orthopedics, and urology) in France was to take stock of practices to identify the protocols used for surgical skin preparation, such as measures relating to pre-operative showering, hair removal, or antisepsis of the operating area. Two pre-operative showers with hair washing are usually carried out on the same day as the procedure (63%) or the day before the procedure (37%), mostly with an antiseptic (54%, soap 42%). Hair removal and cleaning/scrubbing are most often performed before the procedure (in 62% and 79% of cases, respectively). Alcoholic povidone-iodine is the most widely used antiseptic, and 81% of surgeons opt for complete spontaneous drying. Before making the incision, 41% of surgeons use drapes and 62% opt for an operative field irrigation technique during or at the end of the procedure. Surgeons mainly use running subcuticular sutures or running locking sutures (39%) and 93% use dressings. Thirty-six percent of the surgeons surveyed said the antisepsis protocols described were likely to be adapted. The results showed that international and French recommendations are mostly well followed by surgeons and scrub nurses in France. However, some differences are observed between surgical specialties, depending on the clinical situations encountered and the type of practice.