Defining the research agenda for surgical infection: A consensus of experts using the Delphi approach

Background: A substantial proportion of operative procedures are complicated by infections, either remote from or related to the surgical site. These infections account for substantive morbidity and health care costs. With limited research funds available to study interventions designed to either prevent or reduce the morbidity associated with infections in surgical patients, we developed a research agenda to develop priorities to aid in study design and to focus both human and capital resources more effectively. Methods: A Delphi survey approach was used. Consensus was developed among experts in the field of surgical infection and the membership of the Surgical Infection Society. Results: Thirty-six experts generated a total of 62 questions that were submitted for two rounds of consensus ranking. A total of 31 questions were ranked in the final round and are available at www.sisna.org. The most highly ranked question was "Does strict glycemic control compared with standard care reduce the risk of surgical site infection in patients undergoing abdominal surgery?" Most of the questions had little available data, suggesting these are both important and necessary areas for further research. Conclusions: This research agenda, developed by a consensus of experts, provides direction and focus to the development of interventional trials geared toward reducing the morbidity associated with infections in surgical patients.