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).