title: Adherence to international and national recommendations for the prevention of surgical site infections in Italy: results from an observational prospective study in elective surgery.
abstract: BACKGROUND
  An observational prospective study of the perioperative procedures for prevention of surgical site infections (SSIs) was carried out in a tertiary referral teaching hospital in Liguria, Italy, to evaluate their adherence to international and national standards.
  
  
  METHODS
  A 1-month survey was performed in all surgical departments, monitored by turns by trained survey teams. Data regarding presurgical patient preparation and intraoperative infection control practices were collected.
  
  
  RESULTS
  A total of 717 elective interventions were actively monitored in 703 patients who underwent surgery. Hair-shaving was performed mainly using a razor (92%) by the nurses (72.8%) on the day before the operation (83.5%). All of the patients showered, either with a common detergent (87%) or with an antiseptic solution (13%). Antimicrobial prophylaxis was administered properly in 75.7% of the patients at induction of anaesthesia; however, according to current Italian guidelines, inappropriate prophylaxis was provided in 55.2% patients. Appropriate antisepsis of the incision area was done in 97.4% of the operations, and nearly 90% of the interventions lasted less than the respective 75th percentile. The doors of the operating theatres were mostly open during the duration of the operation in 36.3% of the cases.
  
  
  CONCLUSIONS
  This review of infection control policies identified significant opportunities for improving the safety and the quality of routine surgical practice.
authors.affiliation: Department of Health Sciences, University of Genoa, Genoa, Italy. durando@unige.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Durando
authors.forename: Matteo
authors.initials: M
authors.lastname: Bassetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Orengo
authors.forename: Paolo
authors.initials: P
authors.lastname: Crimi
authors.forename: Angela
authors.initials: A
authors.lastname: Battistini
authors.forename: Dorotea
authors.initials: D
authors.lastname: Bellina
authors.forename: Antonella
authors.initials: A
authors.lastname: Talamini
authors.forename: Gabriella
authors.initials: G
authors.lastname: Tiberio
authors.forename: Cristiano
authors.initials: C
authors.lastname: Alicino
authors.forename: Rocco
authors.initials: R
authors.lastname: Iudici
authors.forename: Camilla
authors.initials: C
authors.lastname: Sticchi
authors.forename: Filippo
authors.initials: F
authors.lastname: Ansaldi
authors.forename: Anna
authors.initials: A
authors.lastname: Rossi
authors.forename: Rita
authors.initials: R
authors.lastname: Rosso
authors.forename: Claudio
authors.initials: C
authors.lastname: Viscoli
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Icardi
mesh_terms: D017558:Elective Surgical Procedures / Q000009:adverse effects; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D062606:Tertiary Care Centers