Pre-operative skin preparation practices: results of the 2007 French national assessment.
BACKGROUND
Pre-operative skin preparation, aimed at reducing the endogenous microbial flora, is one of the main preventive measures employed to decrease the likelihood of surgical site infection. National recommendations on pre-operative management of infection risks were issued in France in 2004.


OBJECTIVE
To assess compliance with the French national guidelines for pre-operative skin preparation in 2007.


METHODS
A prospective audit was undertaken in French hospitals through interviews with patients and staff, and observation of professional practice. Compliance with five major criteria selected from the guidelines was studied: patient information, pre-operative showering, pre-operative hair removal, surgical site disinfection and documentation of these procedures.


RESULTS
Data for 41,188 patients from all specialties at 609 facilities were analysed. Patients were issued with information about pre-operative showering in 88.2% of cases [95% confidence interval (CI) 87.9-88.5]. The recommended procedure for pre-operative showering, including hairwashing, with an antiseptic skin wash solution was followed by 70.3% of patients (95% CI 69.9-70.8); this percentage was higher when patients had received appropriate information (P < 0.001). Compliance with hair removal procedures was observed in 91.5% of cases (95% CI 91.2-91.8), and compliance with surgical site disinfection recommendations was observed in 25,529 cases (62.0%, 95% CI 61.5-62.5). The following documentary evidence was found: information given to patient, 35.6% of cases; pre-operative surgical hygiene, 82.3% of cases; and pre-operative site disinfection, 71.7% of cases.


CONCLUSIONS
The essential content of the French guidelines seems to be understood, but reminders need to be issued. Some recommendations may need to be adapted for certain specialties.
Antenne Régionale de Lutte contre les Infections Nosocomiales (ARLIN) de Basse-Normandie, CHU de Caen, Caen Cedex, France. borgey-f@chu-caen.fr
F
F
Borgey
P
P
Thibon
M-A
MA
Ertzscheid
C
C
Bernet
C
C
Gautier
C
C
Mourens
A
A
Bettinger
M
M
Aggoune
E
E
Galy
B
B
Lejeune
Z
Z
Kadi
D000985:Antisepsis / Q000379:methods*; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012867:Skin / Q000382:microbiology*