Over the years, strategies in the prevention and management of surgical site infections (SSI) of patients in the Philippines have never been standardized. Several guidelines released by international foreign bodies have been found to be either conflicting or inappropriate for adaptation in the local context.To address these issues, the Philippine College of Surgeons (PCS),in collaboration with the Philippine Hospital Infection Control Society (PHICS), Philippine Hospital Infection Control Nurses Association (PHICNA) and Operating Room Nurses Association of the Philippines, Inc. (ORNAP), initiated the development and adaptation of country-specific SSI guidelines in 2017. The new recommendations are based on the latest clinical practice guidelines released for the past five years and consensus by a panel of experts in the Philippines, through the assistance of a guideline development team engaged by PCS. Thirty-six (36) recommendations on different aspects of care were outlined. Implementation of an SSI surveillance program was also advised for health facilities.The new guidelines are intended to serve as the local benchmark for the prevention and management of SSI for surgeons and practitioners,taking into account their situation and experience in the Philippines. It is expected to improve the standard of care provided by health facilities and contribute to the reduction of the prevalence and incidence of SSI in the country

Human ; Surgical Wound Infection ; Consensus ; Operating Rooms ; Cross Infection ; Standard Of Care ; Operating Room Nursing ; Perioperative Nursing ; Hospitals ; Surgeons ; Foreign Bodies

Nosocomial infections significantly contribute to a patient’s morbidity and mortality, increasing healthcare costs. While previous research has assessed the effect of oral hygiene on the prevention of nosocomial infections and postoperative complications, few guidelines exist that offer evidence-based recommendations on pre- or peri-operative oral hygiene in the surgical setting. The Philippine Surgical Infection Society set out to develop a set of guidelines that provide evidencebased recommendations on oral hygiene for improving surgical outcomes for adoption in the Philippines. Six clinical questions defined the scope of the guidelines. A systematic review was performed to provide the evidence base to develop the recommendations. A consensus meeting participated by 15 representatives from 13 specialty surgical societies and societies concerned with infection control was conducted using the modified Delphi technique to finalize the set of recommendations. A consensus guideline with sixteen recommendations on the use of oral hygiene to improve surgical outcomes is presented for adoption and implementation.

RATIONALE/OBJECTIVE

This study aimed to determine the knowledge, attitudes and practices of surgeons and surgical trainees regarding published SSI prevention guidelines. Specifically, the study described knowledge and attitudes towards SSI prevention guidelines among members of surgical training programs, described preoperative, intraoperative, and postoperative practices in SSI prevention and identified the presence of surgical site infection surveillance programs among various institutions.

METHODS

This was a retrospective cross-sectional study that evaluated the knowledge, attitudes, and practices of surgeons and surgical trainees to published SSI prevention guidelines in the Philippines. It utilized existing data from an October 2022 online survey done by the Philippine College of Surgeons distributed to various surgical training institutions in the country.

RESULTS

There were a total of 213 respondents. The different attitudes and knowledge gaps towards present SSI prevention guidelines are described.

CONCLUSION

Despite the existence of local and international guidelines there still appears to be a significant lack of awareness and variability in practice among the different institutions as well as with surgeons of different levels of expertise or training. Varying preoperative, intraoperative and postoperative practices have also been described, including evident deviations from SSI guidelines. Lastly, there is a lack of standardized SSI surveillance programs among institutions and these are not aligned towards improved patient safety and quality improvement.

Human ; Surgical Wound Infection

Objective. This study aimed to assess compliance with current best practice guidelines on the use of antibiotics in the Department of Surgery in the Philippine General Hospital and to determine the impact of the dissemination of an institution-based guideline on compliance and on patient outcomes. Methods. Two antibiotic use surveys were performed 4 weeks before and 4 weeks after the implementation and dissemination of the PGH Surgical Antibiotic Use Guidelines in the Department of Surgery. The medical records of eligible patients were reviewed regarding patient and case characteristics, details on the administration of antibiotics and the collection of specimen for culture studies. Data relating to the occurrence of surgical site infection within 30 days of the operation was extracted. Compliance with antibiotic use guidelines was assessed for each case. The compliance rates in the pre- and post-intervention periods were compared. Results. The study included a total of 477 patients, 213 in the pre-implementation and 264 in the post-implementation period. Compared with the pre-intervention period, rates of compliance with guidelines improved for all parameters in the post-implementation period except for correct dosing. The greatest improvement was seen in the selection of the recommended drug, and proper duration. There was modest improvement in the timing of the preoperative drug administration. There was poor compliance with recommendations for appropriate specimen collection for culture studies, with marked improvement in collection in the pediatric group post-intervention. Overall, the in-hospital SSI rate was reduced from 6.8% to 1.1%, while there was little change in the 30-day SSI rate, post-intervention. Conclusion. A simple intervention to raise awareness of institutional guidelines on antibiotic use in the surgical setting lead to a modest improvement on overall compliance, although rates of total compliance with all relevant guidance on antibiotic use, choice, dose, timing and duration remained low. The impact on surgical site infection rates based on such compliance was modest.
Anti-Bacterial Agents