Implementation Strategies for Preventing Healthcare-Associated Infections across the Surgical Pathway: An Italian Multisociety Document.

Healthcare-associated infections (HAIs) result in significant patient morbidity and can prolong the duration of the hospital stay, causing high supplementary costs in addition to those already sustained due to the patient's underlying disease. Moreover, bacteria are becoming increasingly resistant to antibiotics, making HAI prevention even more important nowadays. The public health consequences of antimicrobial resistance should be constrained by prevention and control actions, which must be a priority for all health systems of the world at all levels of care. As many HAIs are preventable, they may be considered an important indicator of the quality of patient care and represent an important patient safety issue in healthcare. To share implementation strategies for preventing HAIs in the surgical setting and in all healthcare facilities, an Italian multi-society document was published online in November 2022. This article represents an evidence-based summary of the document.

Laparoscopic Duodenal Diverticulectomy via the Inframesocolic Route.

The duodenum is traditionally reached and dissected by an anterior approach. Optimal exposure is achieved via complete hepatic flexure mobilization and kocherization of the duodenum and head of the pancreas, which can be technically challenging and time-consuming, especially in the setting of minimally invasive surgery. On the contrary, an inframesocolic approach provides a ready and neat access to the second and third segments of the duodenum with distinct advantages in terms of exposure and operative time. This video presents the details of our laparoscopic technique of approaching the duodenum via the inframesocolic route, as performed to treat a patient with symptomatic duodenal diverticulum.

A proposal for a comprehensive approach to infections across the surgical pathway.

Despite evidence supporting the effectiveness of best practices in infection prevention and management, many healthcare workers fail to implement them and evidence-based practices tend to be underused in routine practice. Prevention and management of infections across the surgical pathway should always focus on collaboration among all healthcare workers sharing knowledge of best practices. To clarify key issues in the prevention and management of infections across the surgical pathway, a multidisciplinary task force of experts convened in Ancona, Italy, on May 31, 2019, for a national meeting. This document represents the executive summary of the final statements approved by the expert panel.