METHOD:
A nationwide confidential online survey (Table 2) was distributed to UK-based junior registrars (ST3-5), senior registrars (ST6-8), post-CCT fellows, specialist associates/staff grade doctors and consultants working in general/vascular surgery, neurosurgery, otolaryngology, oral & maxillofacial surgery and plastic surgery. Dissemination platforms included social media and local and national trust based internal mail. Demographic data including the participant’s grade, region of employment and parent speciality were collected, all respondents remaining anonymous. The survey was tailored to each speciality, with specific questions about materials that reflected commonly used products in their surgical practice. Each participant was given the name of three biological materials which would be used in their speciality and asked to correctly identify the derivative. These questions equally represented the three categories of biological material we have previously outlined (grafts, haemostats, and sealants). Each participant was also asked whether they currently routinely consent for the use of biological material intra-operatively and if they felt that further education in this area would be of value for clinicians.
The survey was created online and distributed via a weblink using social media and email correspondence. Data was analysed using Microsoft Excel. This weblink survey was live for 4 months from November 2019 to February 2020.
RESULTS: Data was collected from a total of 308 survey respondents.
Of the respondents, 34% were consultants (n=105), 29% senior registrars and post-CCT fellows (n=88), 25% junior registrars (n=77) and 12% specialist associates/staff grades (n=38). The largest proportion of responses were obtained within the West Midlands deanery (n=71, 23%) and then by London deaneries (n=46, 15%). The breakdown for the responses collected in other deaneries are summarised below (Table 3).
General and vascular surgery was the most represented speciality (n=120, 39%), followed by otolaryngology (n=109, 35%), neurosurgery (n=34, 11%), plastic surgery (n=24, 8%) and lastly oral & maxillofacial surgery (n=21, 7%), (Table 4).
Biological derivatives were correctly identified in surgical products by only 25% of survey respondents. Within this, 80 survey respondents identified the correct biological derivative for grafts (26%), 62 for haemostats (20%) and 85 for sealants (28%). The correct response rate for all the materials by speciality is summarised in table 4. Our results demonstrate a poor awareness about the constituents of the products surgeons commonly use across all specialties.
There was no observed significance in correct response rate between the grade of surgeon. Overall, all grades demonstrated poor knowledge in this area (Table 4).
Of the total 308 survey participants, 19% stated that they regularly consent for use of these products. Analysing the individual surgical specialties included in this survey, otolaryngologists most commonly consent routinely for the use of biological materials during surgery (23%), with oral and maxillofacial surgeons most infrequently (10%). An overwhelming 74% of participants agreed that further education on the intra-operative use of biological materials would be valuable (Table 5).