부산대학교 도서관

Background Most clinical guidelines are developed by high-income country institutions with little consideration given to either the evidence base for interventions in low- and middle-income countries (LMICs), or the specific challenges LMIC health systems may face in implementing recommendations. The aim of this study was to prioritize topics for future global surgery guidelines and then to develop a guideline for the top ranked topic. Methods A Delphi exercise identified and prioritized topics for guideline development. Once the top priority topic had been identified, relevant existing guidelines were identified and their recommendations were extracted. Recommendations were shortlisted if they were supported by at least two separate guidelines. Following two voting rounds, the final recommendations were agreed by an international guideline panel. The final recommendations were stratified by the guideline panel as essential (baseline measures that should be implemented as a priority) or desirable (some hospitals may lack these resources at present, in which case they should plan for future implementation). Results Prevention of surgical-site infection (SSI) after abdominal surgery was identified as the highest priority topic for guideline development. The international guideline panel reached consensus on nine essential clinical recommendations for prevention of SSI. These included recommendations concerning preoperative body wash, use of prophylactic antibiotics, decontamination of scrub teams' hands, use of antiseptic solutions for surgical site preparation and perioperative supplemental oxygenation. In addition, three desirable clinical recommendations and four recommendations for future research were agreed. Conclusion This process led to the development of a global surgery guideline for the prevention of SSI that is both clinically relevant and implementable in LMICs. CAPTION(S): Appendix S1. Supporting Information A PDF of the summary recommendations is available and free to download in the Supporting Information section online. Byline: , Dmitri Nepogodiev, Adewale Adisa, Francis Atindaana Abantanga, Adesoji Ademuyiwa, Sohini Chakrabortee, Dhruva Ghosh, James Glasbey, Marie Carmela Lapitan, Ismail Lawani, Mayaba Maimbo, Rachel Moore, Dion Morton, Faustin Ntirenganya, Ahmad Uzair Qureshi, Antonio Ramos-De la Medina, Stephen Tabiri, Thomas Pinkney, Aneel Bhangu, Adesoji Ademuyiwa, Anthony Adenekan, Abdus-sami Adewunmi, Adewale Adisa, Maria Lorena Aguilera, Aneel Bhangu, Bruce Biccard, Peter Brocklehurst, Sohini Chakrabortee, Ainhoa Costa, Philip Cotton, Justine Davies, Thomas M. Drake, O. James Garden, Dhruv Ghosh, James Glasbey, Parvez David Haque, Ewen M. Harrison, Jean De La Croix Allen Ingabire, Stephen R. Knight, Marie Carmela Lapitan, Ismail Lawani, Richard Lilford, Mayaba Maimbo, Janet Martin, Luis Hernandez Miguelena, Rohin Mittal, Rachel Moore, Dion Morton, Vanessa Msosa, Syed Asghar Naqi, Dmitri Nepogodiev, Faustin Ntirenganya, Jean Leon Olory-Togbe, Omar Mohamed Omar, Thomas D. Pinkney, Ahmad Uzair Qureshi, Antonio Ramos-De la Medina, Hosni Khairy Salem, Martin Smith, Sudha Sundar, Stephen Tabiri, Edwin Yenli, Raul Yepez, Eugene Zoumenou, Francis Atindaana Abantanga, Adesoji Ademuyiwa, Abdus-sami Adewunmi, Adewale Adisa, Maria Lorena Aguilera, Aneel Bhangu, Bruce Biccard, Peter Brocklehurst, Sohini Chakrabortee, Ainhoa Costa, Thomas M. Drake, Dhruva Ghosh, James Glasbey, Parvez David Haque, Ewen M. Harrison, Jean De La Croix Allen Ingabire, Conor S Jones, Chifundo Kajombo, Stephen R. Knight, Marie Carmela Lapitan, Ismail Lawani, Samuel Lawday, Mayaba Maimbo, Janet Martin, Luis Hernandez Miguelena, Rohin Mittal, Rachel Moore, Dion Morton, Vanessa Msosa, Syed Asghar Naqi, Dmitri Nepogodiev, Faustin Ntirenganya, Martin Nyundo, Jean Leon Olory-Togbe, Thomas D. Pinkney, Ahmad Uzair Qureshi, Antonio Ramos-De la Medina, Dione Parreno-Sacdalan, Hosni Khairy Salem, Martin Smith, Stephen Tabiri, Edwin Yenli, Eugene Zoumenou