Perioperative Antimicrobial Prophylaxis: Knowledge, Beliefs, and Practices Among Plastic Surgeons in Upper Limb Surgeries.

BACKGROUND

Surgical antimicrobial prophylaxis (SAP) is vital for preventing surgical site infections (SSIs). However, variability in SAP practices and the inappropriate use of antibiotics pose significant challenges in upper limb surgery. Despite its importance, no unified guidelines exist to standardize SAP practices. This study aimed to evaluate the knowledge, beliefs, and practices of plastic surgeons regarding SAP in upper limb and hand surgeries.

METHODS

This cross-sectional study was conducted using an online self-administered survey distributed to all Saudi plastic surgeons in March 2023. The questionnaire comprised 13 items assessing demographic characteristics, SAP practices in patients with clean and contaminated surgeries, and awareness of existing guidelines. Analyses were performed using IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.

RESULTS

A total of 65 plastic surgeons were included in the study. The majority (n = 58, 89.2%) were employed in the government sector, whereas 35.4% (n = 23) had 10-15 years of work experience. Most participants administered antibiotics preoperatively for clean (n = 56, 86.2%) and contaminated (n = 63, 96.9%) hand and upper limb surgeries, with higher administration rates observed in contaminated cases. Cefazolin was the most frequently used antibiotic preoperatively (n = 49, 75.4%), while amoxicillin-clavulanate was the preferred postoperative antibiotic for both clean (n = 31, 47.7%) and contaminated (n = 36, 55.4%) hand surgeries. Although 61.5% (n = 40) of the surgeons were aware of SAP guidelines, 30.8% (n = 20) cited a lack of consensus as the key factor influencing their decisions. No significant differences were observed between workplace environments and SAP practices (all χ² tests, p > 0.05).

CONCLUSION

The findings indicate substantial variability in SAP practices among Saudi plastic surgeons, highlighting the need for clear, evidence-based guidelines to optimize patient care.