A cross-specialty, evidence-based Delphi consensus of a care bundle to reduce surgical site infections
Year: 2026
Type: article
Abstract: BACKGROUND: Surgical site infections (SSI) are among the most frequently observed healthcare associated infections and represent a significant target to reduce the impact of antimicrobial resistance. Use of a surgical care bundle has demonstrated efficacy in reduction in SSI, but there is a lack of consensus on which elements should be included within such a bundle. The aim of this international consensus was to determine what factors should be utilized to produce an optimal, evidence-led bundle of care that can be utilized in a multidisciplinary manner across specialties and across countries. METHODS: The process employed a modified Delphi methodology. Based on published high-level evidence an international multidisciplinary steering group developed 38 statements for testing with a wider responder panel of healthcare professionals in Europe. The threshold for consensus agreement was set at 75%. RESULTS: A total of 820 responses were analyzed, with the majority of participants being surgeons (59%) and nurses (19.1%) from across Europe. The consensus process evaluated 36 finalized statements covering preoperative, intraoperative, and postoperative SSI prevention practices. Overall, 33 out of 36 statements (92%) reached the predefined consensus threshold of 75% agreement. A high agreement was observed across multiple roles and specialties, although some variation existed for specific topics such as antiseptic irrigation, use of antimicrobial sutures, and plastic adhesive drapes. CONCLUSION: This large consensus of European HCPs involved in the surgical care of patients achieved strong levels of consensus across most of the proposed statements on elements of an SSI prevention bundle. These practice recommendations could be adopted as an evidence- and expert-based care bundle for the prevention of SSI. The project was registered at www.researchregistry.com.
Source: International Journal of Surgery
Institutions: Universitat Internacional de Catalunya, Hospital General de Granollers, Inserm, Université de Poitiers, Centre Hospitalier Universitaire de Poitiers, Pharmacologie des anti-infectieux et antibiorésistance, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Universitat de València, Hospital General Universitario De Valencia, University of Hull, University of Zurich, University Hospital Zurich, Queensland University of Technology, Amsterdam University Medical Centers, Amsterdam Gastroenterology Endocrinology Metabolism, University of Amsterdam
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,450
OpenAlex ID: W7124138145