Implementation of a care bundle and evaluation of risk factors for surgical site infection in cranial neurosurgery

Davies, Benjamin; Jones, Anna; Patel, Hiren C.

doi:10.1016/j.clineuro.2016.03.025

Cited by 40 publications

(37 citation statements)

References 27 publications

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“…Well-known risk factors are diabetic status, smoking history, long hospital stay, prior surgery, long duration of surgery, ventricular drainage, cerebrospinal fluid leakage, and implantations. 1–6,10–13) Schipmann et al reported 20 independent risk factors for SSI after cranial neurosurgical procedures. 1) Some of those factors were present in our SSI cases.…”

Section: Discussionmentioning

confidence: 99%

Surgical Site Infection after Malignant Brain Tumor Resection: A Multicenter Study for Induction of a Basic Care Bundle

Uzuka

Takahashi

Nakasu

et al. 2017

Neurol. Med. Chir.(Tokyo)

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Patients with malignant brain tumors are possibly at increased risk for surgical site infections (SSIs) considering the various medical situations associated with the disease. However, the actual rate of SSI after malignant brain tumor resection has not been well established, despite the potential impact of SSI on patient outcome. To investigate the incidence of SSI following malignant brain tumor surgery, we performed a retrospective study in 3 neurosurgical units. Subsequently, aiming at the reduction of incidence of SSI, we performed a prospective study using a care bundle technique in the same units. The SSI incidence in the retrospective (n = 161) and prospective studies (n = 68) were 4.3% and 4.4%, respectively, similar to the previously reports on general craniotomies. A care bundle does not appear to enhance prevention of SSI. However, future, large studies with a new care bundle should be planned based on a zero tolerance policy.

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Section: Discussionmentioning

confidence: 99%

Surgical Site Infection after Malignant Brain Tumor Resection: A Multicenter Study for Induction of a Basic Care Bundle

Uzuka

Takahashi

Nakasu

et al. 2017

Neurol. Med. Chir.(Tokyo)

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“…Osteomyelitis can also rarely occur after neurosurgical interventions. This can occur 1 to 12 months after an intervention [28] and is usually caused by Staphylococcus aureus [29]. Purulent osteomyelitis is acute and chronic.…”

Section: Definition and Locationmentioning

confidence: 99%

Cross Sectional Imaging of Solitary Lesions of the Neurocranium

Schäfer

Koch

Streitparth

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TBackground Although a wide range of processes along the neurocranium are of a benign nature, there are often difficulties in the differential diagnosis.Method In the review CT/MRI scans of the head were evaluated retrospectively regarding solitary lesions along the neurocranium. The majority of the lesions were histologically proven.Results The purpose of the review is to present typical pathologies of the neurocranium and provide a systematic overview based on 12 entities, their locations, prevalence and radiological characteristics.Conclusion Processes, which primarily originate from the neurocranium have to be differentiated from secondary processes infiltrating the neurocranium. For this important diagnostic feature, MRI is typically essential, while the definitive diagnosis is often made on the basis of the medical history and the typical appearance on computer tomography. Key Points▪ There are often difficulties in the precise differential diagnosis of solitary lesions along the neurocranium. Typical solitary pathologies of the neurocranium based on 12 entities were presented. Both magnetic resonance imaging and computed tomography are often essential for an exact differential diagnosis. Schlussfolgerung Unterschieden werden müssen Prozesse, die primär vom Neurokranium ausgehen, von sekundären Prozessen, die das Neurokranium infiltrieren. Für dieses wichtige diagnostische Merkmal ist die MRT meistens unverzichtbar, während die definitive Diagnose dann unter Berücksichti-gung der Anamnese mit dem typischen Erscheinungsbild in der CT häufig gestellt werden kann.

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“…As a generic term, 'Bundled intervention', has been utilized by studies external to this review, although generally with different meanings across different clinical settings. 43,44 In contrast to observational studies, the results from RCTs did not achieve statistical significance for the patient care bundle. Three of the included RCTs that assessed nasal decolonization had no reduction in SSI rate.…”

Section: Discussionmentioning

confidence: 82%

“…One of six systematic reviews used the term ‘bundle’ to compare with standard care; however, neither ‘bundle’ nor ‘standard care’ was clearly specified. As a generic term, ‘Bundled intervention’, has been utilized by studies external to this review, although generally with different meanings across different clinical settings …”

Section: Discussionmentioning

confidence: 99%

“…In contrast, we observed that the majority of the observational studies reported a treatment standardization process, which included optimized antibiotic regimens 19,22,23,35 and improved compliance in nasal decolonization. 18,43,45 While the observational studies demonstrated greater effectiveness, they are more vulnerable to bias, or confounding factors, although they are more likely to reflect reallife clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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Systematic review of a patient care bundle in reducing staphylococcal infections in cardiac and orthopaedic surgery

Cameron

Tivey

et al. 2017

ANZ Journal of Surgery

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Surgical site infections (SSIs) are serious adverse events hindering surgical patients' recovery. In Australia and New Zealand, SSIs are a huge burden to patients and healthcare systems. A bundled approach, including pre-theatre nasal and/or skin decolonization has been used to reduce the risk of staphylococcal infection. The aim of this review is to assess the effectiveness of the bundle in preventing SSIs for cardiac and orthopaedic surgeries. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Published literature was searched in PubMed, Embase and Cochrane Library of Systematic reviews. Identified articles were selected and extracted based on a priori defined Population-Intervention-Comparator-Outcome and eligibility criteria. Data of randomized controlled trials (RCTs) and comparative observational studies were synthesized by meta-analyses. Quality appraisal tools were used to assess the evidence quality. The review included six RCTs and 19 observational studies. The bundled treatment regimens varied substantially across all studies. RCTs showed a trend of Staphylococcus aureus SSIs reduction due to the bundle (relative risk = 0.59, 95% confidence interval (CI) = 0.33, 1.06) with moderate heterogeneity. Observational studies showed statistically significant reduction in all-cause and S. aureus SSIs, with 51% (95% CI = 0.41, 0.59) and 47% (95% CI = 0.35, 0.65), respectively. No publication biases were detected. SSIs in major cardiac and orthopaedic surgeries can be effectively reduced by approximately 50% with a pre-theatre patient care bundle approach.

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Implementation of a care bundle and evaluation of risk factors for surgical site infection in cranial neurosurgery

Cited by 40 publications

References 27 publications

Surgical Site Infection after Malignant Brain Tumor Resection: A Multicenter Study for Induction of a Basic Care Bundle

Surgical Site Infection after Malignant Brain Tumor Resection: A Multicenter Study for Induction of a Basic Care Bundle

Cross Sectional Imaging of Solitary Lesions of the Neurocranium

Systematic review of a patient care bundle in reducing staphylococcal infections in cardiac and orthopaedic surgery

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