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Surgical site infections represent a considerable burden for healthcare systems. To obtain a consensus on the impact and future clinical and economic needs regarding SSI management in an era of multidrug resistance. A modified Delphi method was used to obtain consensus among experts from five European countries. The Delphi questionnaire was assembled by a steering committee, verified by a panel of experts and administered to 90 experts in 8 different surgical specialities Abdominal, Cancer, Cardiac, General surgery, Orthopaedic, Thoracic, Transplant and Vascular and three other specialities infectious disease, internal medicine microbiology.
There was strong positive consensus on the cost-effectiveness of early discharge ED programs, improvement of quality of life with ED and association between increased length of stay and economic burden to the hospital.
However, established ED protocols were not widely available in their hospitals. Respondents expressed a positive consensus on the usefulness of antibiotics that allow ED. Surgeons are aware of their responsibility in an interdisciplinary team for the treatment of SSI, and of the impact of multidrug-resistant bacteria in the context of SSI.
Reducing the length of hospital stays by applying ED protocols and implementing new treatment alternatives is crucial to reduce harm to patients and costs for the hospital. Despite proper precautions, surgical site infections SSI remain a major challenge, comprised The incidence of SSIs is projected to increase as an aging population and increasing obesity lead to more procedures [ 3 ]. Immunosuppressed, obese and diabetic patients are also at higher risk [ 6 , 7 ]. Causative pathogens are usually commensal bacteria associated with the surgical site [ 8 ], and thus tend to vary according to the procedure [ 9 ].