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 21 February 2018

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News

Reducing surgical site infections in a high-outlier colorectal unit

The latest issue of the Diseases of the Colon & Rectum investigates an effective bundled approach reduces surgical site infections in a high-outlier colorectal unit.

News image

Surgical site infections are the most common hospital-acquired infection after colorectal surgery, increasing morbidity, mortality, and hospital costs.

Dr Emre Gorgun and colleagues investigated the impact of preventive measures on colorectal surgical site infection rates in a high-volume institution that performs inherent high-risk procedures.

The team conducted a study at a high-volume, specialized colorectal surgery department.

The Prospective Surgical Site Infection Prevention Bundle Project included 14 preoperative, intraoperative, and postoperative measures to reduce surgical site infection occurrence after colorectal surgery.

Surgical site infections within 30 days of the index operation were examined for patients during the 1-year period after the surgical site infection prevention bundle was implemented.

56% of surgical procedures occurred after the bundle project
Diseases of the Colon & Rectum

The team compared data collection and outcomes for this period with the year immediately before the implementation of bundle elements.

All of the patients who underwent elective colorectal surgery by a total of 17 surgeons were included.

The researchers excluded ileostomy closure and anorectal and enterocutaneous fistula repair from the analysis.

The team's main outcome was surgical site infection occurring within 30 days of the index operation was measured.

Surgical site infection–related outcomes after implementation of the bundle were compared with same period a year before the implementation of bundle elements.

Between 2013 and 2015, the team found that 2250 abdominal colorectal surgical procedures were performed, including 44% during the prebundle period, and 56% after the bundle project.

Patient characteristics and comorbidities were similar in both periods.

The team noted that compliance with preventive measures ranged between 75% and 99% during the bundle period.

The research team found that overall surgical site infection rate decreased from 1% prebundle to 7% at the bundle period.

Although a decrease for all types of surgical site infections was observed after the bundle implementation, a significant reduction was achieved in the organ-space subgroup.

Dr Gorgun's team comments, "The prospective Surgical Site Infection Prevention Bundle Project resulted in a substantial decline in surgical site infection rates in our department."

"Collaborative and enduring efforts among multiple providers are critical to achieve a sustained reduction."

Dis Colon Rectum 2018: 61(1): 89–98
17 January 2018

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