BACKGROUND Surgical site infection (SSI) is one of the most common hospital-acquired infections and is associated with serious impact on the rates of morbidity, mortality as well as healthcare costs. This study examined factors influencing the application of several intraoperative preventive measures of SSI by surgeons and surgical residents in the Gaza Strip. METHODS A cross-sectional study was conducted from December 2016 to February 2017 at the operation rooms of the three major hospitals located in the Gaza-Strip, Palestine. Inclusion criteria for patients were being adult (aged ≥18 years), no history of wound infection at time of operation and surgical procedure under general anaesthesia with endotracheal intubation. The association between different patient- and procedure-related SSI risk factors and adherence to several intraoperative SSI preventive measures was tested. RESULTS In total, 281 operations were observed. The mean patient age ± standard deviation (SD) was 38.4 ± 14.6 years and the mean duration of surgery ± SD was 58.2 ± 32.1 minutes. A hundred-thirty-two patients (47.0%) were male. Location and time of the operation were found to have significant associations with adherence to all SSI preventive measures except for antibiotic prophylaxis. Type of operation had a significant association with performing all measures except changing surgical instruments. Patient age did not have a statistically significant association with adherence to any measure. CONCLUSION The results suggest that the surgeon could be a major factor that can lead to a better outcome of surgical procedures by reducing postoperative complications of SSI. Operating department professionals would benefit from clinical guidance and continuous training, highlighting the importance of persistent implementation of SSI preventive measures in everyday practice to improve the quality of care provided to surgical patients.

中文翻译：

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加沙地带医院外科医生对手术部位感染的预防性术中措施的依从性的决定因素：一项多中心横断面研究。

背景技术手术部位感染（SSI）是最常见的医院获得性感染之一，并且与发病率，死亡率以及医疗费用的严重影响有关。这项研究探讨了影响加沙地带的外科医师和外科手术居民采用几种术中SSI预防措施的因素。方法2016年12月至2017年2月在巴勒斯坦加沙地带的三家主要医院的手术室进行了横断面研究。患者的纳入标准为成人（≥18岁），在气管内插管全麻下手术和手术时无伤口感染史。测试了不同的患者和手术相关的SSI危险因素与术中SSI预防措施的依从性之间的关联。结果总共观察到281例手术。平均患者年龄±标准差（SD）为38.4±14.6岁，平均手术时间±SD为58.2±32.1分钟。一百三十二名患者（47.0％）是男性。发现手术的地点和时间与遵守除抗生素预防以外的所有SSI预防措施的关系密切。手术类型与执行所有措施（更换手术器械除外）有显着关联。患者年龄与任何措施的依从性在统计学上均无显着相关性。结论结果表明，外科医生可能是减少SSI术后并发症的主要原因，可以导致更好的手术结果。运营部门的专业人员将从临床指导和持续培训中受益，这突显了在日常实践中持续实施SSI预防措施以提高为手术患者提供的护理质量的重要性。