Observed practices in surgical site infection prevention in Ukraine: national survey results from 2021 and 2025

Surgical site infections (SSIs) remain among the most frequent healthcare-associated infections worldwide and are associated with significant morbidity, mortality, and healthcare costs. Despite availability of evidence-based guidelines, adherence to SSI prevention measures varies substantially across countries and institutions. In Ukraine, reliable data describing SSI prevention practices remain limited due to absence of nation-wide monitoring of infection prevention and control practices.

We conducted two rounds of a national survey among surgeons and anaesthesiologists in Ukraine in 2021 and 2025. The survey was based on the World Health Organization (WHO) Global Guidelines for the Prevention of Surgical Site Infection (2018 edition) and assessed knowledge, attitudes, and self-reported adherence to recommended and non-recommended SSI prevention practices. Both surveys were distributed online via professional societies' platforms, targeting practicing surgeons and anaesthesiologists across different levels of healthcare facilities.

In 2021, a total of 294 responses were received, followed by 145 responses in 2025. Across both survey periods, respondents represented a wide range of clinical specialties and geographic regions, with anaesthesiologists comprising the majority. In the 2025 survey, perioperative antimicrobial prophylaxis was reported as universally practiced (100%). In addition, active intraoperative warming was implemented by 82.6% of respondents and goal-directed fluid therapy by 93.8%. Despite these encouraging figures, several evidence-based measures were only partially adopted. For instance, alcohol-based chlorhexidine for skin preparation was used by 51%, surgical hand preparation with antiseptic soap by 60%, and intensive perioperative blood glucose control by 71.7% of respondents. Conversely, certain non-recommended practices, such as extended antimicrobial prophylaxis after surgery, remained prevalent, with 82.6% of respondents reporting its use. Although self-rated knowledge of WHO guidelines was generally high, notable gaps between awareness and actual practice were observed.

This national survey, conducted in two rounds (2021 and 2025), was instrumental in understanding which SSI prevention practices are currently used in Ukraine. The continued use of non-recommended practices remains evident. These results underscore the need for targeted educational interventions, systematic monitoring, and strengthened institutional support to improve adherence to evidence-based guidelines and ultimately reduce the burden of SSIs nationwide.