Prophylaxis and management of wound infections after elective colorectal surgery: a survey of the American Society of Colon and Rectal Surgeons membership.
BACKGROUND
Postoperative wound infections are a widespread and costly problem, especially in colorectal surgery. Despite their prevalence, there are few data regarding appropriate management and prevention strategies.


METHODS
In order to assess current attitudes and practices about this subject, and as a guide to designing a randomized trial to gather evidence in order to support data-driven protocol development, an e-mail survey was sent to the membership of the American Society of Colorectal Surgeons to assess current attitudes and practices pertaining to prevention and management of wound infections.


RESULTS
Most respondents estimated that the wound infection rate in their own patients was much lower than commonly reported in the literature. Use of evidence-based perioperative strategies for reducing wound infection, such as the use of a wound protector, hyperoxygenation, and implementation of the Surgical Care Improvement Project guidelines, were far from universal. Management strategies varied widely, without apparent rational basis.


CONCLUSIONS
Based on the practices and beliefs in the surgical community, it is our hope that a multi-institutional study can be carried out to objectify best practices in both the effective and cost-effective management of this common condition and to reduce the wide variation in the treatment of surgical site infections.
Markell
Katharine W
KW
Swedish Colon & Rectal Clinic, 1101 Madison, Seattle, WA 98104, USA.
Hunt
Ben M
BM
Charron
Paul D
PD
Kratz
Rodney J
RJ
Nelson
Jeffrey
J
Isler
John T
JT
Steele
Scott R
SR
Billingham
Richard P
RP
D001291:Attitude of Health Personnel; D003106:Colon / Q000601:surgery*; D003625:Data Collection; D017558:Elective Surgical Procedures; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D012007:Rectum / Q000601:surgery*; D012955:Societies, Medical; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy*; D014481:United States
J Trauma. 2007 Jan;62(1):212-5
17215757
N Engl J Med. 2000 Jan 20;342(3):161-7
10639541
Am J Infect Control. 1996 Oct;24(5):380-8
8902113
J Am Coll Surg. 2007 Sep;205(3):432-8
17765159
JAMA. 2005 Oct 26;294(16):2035-42
16249417
Arch Surg. 2005 Feb;140(2):174-82
15724000
Chest. 1992 Oct;102(4 Suppl):305S-311S
1395818
Lancet. 2007 Dec 22;370(9605):2112-7
18156032
Cochrane Database Syst Rev. 2009 Jan 21;(1):CD001544
19160198
Surgery. 2007 Nov;142(5):704-11
17981191
Clin Infect Dis. 2005 Nov 15;41(10):1373-406
16231249
Arch Surg. 2008 Feb;143(2):189-96
18283145
J Antimicrob Chemother. 2006 Apr;57(4):589-608
16507559
Plast Reconstr Surg. 2006 Jun;117(7 Suppl):59S-71S
16799375
Infect Control Hosp Epidemiol. 1992 Oct;13(10):606-8
1334988
Lancet. 1999 May 8;353(9164):1585
10334259
Am J Obstet Gynecol. 1996 Aug;175(2):358-61; discussion 362
8765253
Ann Surg. 2004 May;239(5):599-605; discussion 605-7
15082963
Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006214
18646139
Plast Reconstr Surg. 2006 Aug;118(2):390-7; discussion 398-400
16874208