Deslandes Antoine, Christou Niki, Baillet Patrice, Hajjar Joseph, Marre Philippe, Johanet Hubert, Leone Marc, Birgand Gabriel
Regional Center for Infection Prevention and Control (CPias), Region of Pays de la Loire, Nantes University Hospital, 5 rue du Pr Yves Bocquien, Nantes, 44000, France.
Académie Nationale de Chirurgie, Paris, France.
Antimicrob Resist Infect Control. 2025 May 28;14(1):57. doi: 10.1186/s13756-025-01576-9.
Although it generates a significant burden, little attention has been paid to preventing Surgical Site Infection (SSI) in digestive surgery.
This study explored the factors underpinning anesthetists' and surgeons' attitudes toward SSI prevention in digestive surgery, focusing on their perceptions of SSI, preventive measures, guidelines, and cooperation across both specialties.
Qualitative semi-structured interviews were conducted with 15 surgeons and 19 anesthetists working in digestive surgery. Participants were approached through established mailing lists and snowball sampling. Interviews were recorded and transcribed verbatim. Transcripts were coded and analyzed thematically using a constant comparative approach.
SSI in digestive surgery was perceived as an inevitable consequence and ranked down in the priorities of surgeons. A paradox existed between the low consideration of superficial infections that are easily manageable through antibiotics and the strong awareness of the antibiotic resistance threat. Global trust appeared regarding the guidelines, but a knowledge gap of the guidelines was observed among surgeons in comparison with anesthetists. SSI ownership was perceived as collective, but the responsibility belonged to the surgeon alone. Surgeons focused on actions and short-term tasks within a culture of individualism, whereas anesthetists worked collectively with systemic approaches. Overall, the cooperation between both specialties was positive, but tightly reliant on teamwork, workload, and organization in the operating theatre.
The cultural differences between surgeons and anesthetists should be recognized as a key overarching factor in defining their respective roles in the prevention of SSI and in establishing accountability in digestive surgery - including aspects such as adherence to guidelines, and the implementation of preventive measures.
尽管手术部位感染（SSI）造成了巨大负担，但在消化外科手术中，预防SSI却很少受到关注。
本研究探讨了麻醉师和外科医生对消化外科手术中预防SSI态度的影响因素，重点关注他们对SSI的认知、预防措施、指南以及两个专业之间的合作。
对15名从事消化外科手术的外科医生和19名麻醉师进行了定性半结构化访谈。通过已有的邮件列表和滚雪球抽样的方式联系参与者。访谈进行了录音，并逐字转录。使用持续比较法对转录文本进行编码和主题分析。
消化外科手术中的SSI被视为不可避免的后果，在外科医生的优先事项中排名靠后。在通过抗生素易于控制的浅表感染被低度重视与对抗生素耐药性威胁的强烈意识之间存在矛盾。对指南总体上是信任的，但与麻醉师相比，外科医生对指南存在知识差距。SSI的责任被视为是集体的，但责任仅属于外科医生。外科医生在个人主义文化中关注行动和短期任务，而麻醉师则采用系统方法进行集体工作。总体而言，两个专业之间的合作是积极的，但紧密依赖于手术室的团队合作、工作量和组织安排。
外科医生和麻醉师之间的文化差异应被视为一个关键的总体因素，在界定他们在预防SSI中的各自角色以及在消化外科手术中确立责任方面——包括遵守指南和实施预防措施等方面。
