Incidence and impact of surgical site infections on length of stay and cost of care for patients undergoing open procedures

Hou, Yuefeng; Collinsworth, Ashley; Hasa, Flutura; Griffin, Leah

doi:10.1016/j.sopen.2022.10.004

Cited by 28 publications

(30 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Relative reduction rate was taken from the high‐risk subgroup meta‐analysis (61.0%, Table 3). Overall cost per SSI was estimated at $45578 5 . Total cost per patient was estimated to be $2911 for ciNPT‐F and $6153 for SOC, resulting in at $3242 potential savings per patient with ciNPT‐F use in the high‐risk population.…”

Section: Resultsmentioning

confidence: 99%

“…SSI development following cardiac surgery can be a serious complication resulting in increased morbidity and mortality rates and cost of care 1–5 . ciNPT is available as a post‐surgical tool to help manage the closed incision and has been reported to reduce the incidence of SSI across other surgical specialties.…”

Section: Discussionmentioning

confidence: 99%

“…Reported rates of surgical site infection (SSI) incidence in cardiac surgery have ranged between 0.5% and 25% with mortality rates due to SSIs reaching 25% 1–4 . More recently, overall rates of SSI development after cardiac surgery have been estimated at 1.7% to 1.9% in the United States based on a retrospective review of the Medicare Limited Data Set and the Premier Healthcare database 5 …”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4] More recently, overall rates of SSI development after cardiac surgery have been estimated at 1.7% to 1.9% in the United States based on a retrospective review of the Medicare Limited Data Set and the Premier Healthcare database. 5 Risk factors for SSI development in cardiac surgery include high European System for Cardiac Operative Risk Evaluation (EuroSCORE), high Society of Thoracic Surgeons (STS) score, obesity, diabetes, tobacco use, advanced age (>70 years), chronic obstructive pulmonary disease, heart failure with left ventricular dysfunction, renal failure, female sex, peripheral vascular disease and prolonged length of hospital stay prior to surgery. 1,[6][7][8][9] Additionally, emergency surgery, use of bilateral internal mammary arteries, multiple surgery procedures, prolonged surgery duration, duration of cardiopulmonary bypass, aortic clamping, postoperative respiratory failure, transfusion, prolonged intensive care unit stay and use of inotropic support can also increase the risk of SSI development.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Surgical site infection outcomes of two different closed incision negative pressure therapy systems in cardiac surgery: Systematic review and meta‐analysis

Loubani,

Cooper,

Silverman

et al. 2024

International Wound Journal

Self Cite

View full text Add to dashboard Cite

Closed incision negative pressure therapy (ciNPT) system use compared with standard of care dressings (SOC) on surgical site infection (SSI) in cardiac surgery was assessed. A systematic literature review was conducted. Risk ratios (RR) and random effects models were used to assess ciNPT with foam dressing (ciNPT‐F) or multilayer absorbent dressing (ciNPT‐MLA) versus SOC. Health economic models were developed to assess potential per patient cost savings. Eight studies were included in the ciNPT‐F analysis and four studies were included in the ciNPT‐MLA analysis. For ciNPT‐F, a significant reduction in SSI incidence was observed (RR: 0.507, 95% confidence interval [CI]: 0.362, 0.709; p < 0.001). High‐risk study analysis reported significant SSI reduction with ciNPT‐F use (RR: 0.390, 95% CI: 0.205, 0.741; p = 0.004). For ciNPT‐MLA, no significant difference in SSI rates were reported (RR: 0.672, 95% CI: 0.276, 1.635; p = 0.381). Health economic modelling estimated a per patient cost savings of $554 for all patients and $3242 for the high‐risk population with ciNPT‐F use. Health economic modelling suggests ciNPT‐F may provide a cost‐effective solution for sternotomy incision management. However, limited high‐quality literature exists. More high‐quality evidence is needed to fully assess the impact of ciNPT use following cardiac surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical site infection outcomes of two different closed incision negative pressure therapy systems in cardiac surgery: Systematic review and meta‐analysis

Loubani,

Cooper,

Silverman

et al. 2024

International Wound Journal

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a retrospective analysis using data from the Premier Healthcare Database, a large, US hospital-based, all-payer database, the incidence of 90-day SSCs on open surgical procedures is estimated at 6.4% with a cost per SSC of $17,317. 102 This leads to a mean cost of SSC per patient of $1108. These meta-analyses have demonstrated a 46% risk reduction in SSCs with the use of this ciNPT device.…”

Section: Discussionmentioning

confidence: 99%

Closed Incision Negative Pressure Therapy versus Standard of Care in Reduction of Surgical Site Complications: A Systematic Review and Meta-analysis

Cooper

Singh

Gabriel

et al. 2023

Plastic and Reconstructive Surgery - Global Open

Self Cite

View full text Add to dashboard Cite

Surgical site complications (SSCs), such as surgical site infection (SSI), dehiscence, seroma, hematoma, and skin necrosis, are associated with increased patient morbidity and mortality. 1 Patients who develop SSCs often experience delayed wound healing, decreased quality of life, and increases in length of stay (LOS), medical procedures performed, pain, and potential reoperation and readmission. [1][2][3] Increased use of resources with management Reconstructive ORiginal aRticleIntroduction: Closed incision negative pressure therapy (ciNPT) has been utilized to help manage closed incisions across many surgical specialties. This systematic review and meta-analysis evaluated the effect of ciNPT on postsurgical and health economic outcomes. Methods: A systematic literature search using PubMed, EMBASE, and QUOSA was performed for publications written in English, comparing ciNPT to standard-of-care dressings between January 2005 and August 2021. Study participant characteristics, surgical procedure, dressings used, treatment duration, postsurgical outcomes, and follow-up data were extracted. Meta-analyses were performed using random-effects models. Risk ratios summarized dichotomous outcomes. Difference in means or standardized difference in means was used to assess continuous variables reported on the same scale or outcomes reported on different scales/measurement instruments. Results: The literature search identified 84 studies for analysis. Significant reductions in surgical site complication (SSC), surgical site infection (SSI), superficial SSI, deep SSI, seroma, dehiscence, skin necrosis, and prolonged incisional drainage were associated with ciNPT use (P < 0.05). Reduced readmissions and reoperations were significant in favor of ciNPT (P < 0.05). Patients receiving ciNPT had a 0.9-day shorter hospital stay (P < 0.0001). Differences in postoperative pain scores and reported amounts of opioid usage were significant in favor of ciNPT use (P < 0.05). Scar evaluations demonstrated improved scarring in favor of ciNPT (P < 0.05). Discussion: For these meta-analyses, ciNPT use was associated with statistically significant reduction in SSCs, SSIs, seroma, dehiscence, and skin necrosis incidence. Reduced readmissions, reoperation, length of hospital stay, decreased pain scores and opioid use, and improved scarring were also observed in ciNPT patients.

show abstract

A Quality Improvement Project to Increase Compliance With a Facility Protocol on Surgical Antimicrobial Prophylaxis

Wysocki,

Zedreck Gonzalez,

Ren

2024

AORN Journal

View full text Add to dashboard Cite

Surgical site infections (SSIs) contribute to negative outcomes for patients and health care organizations. Compliance with clinical practice guidelines likely can help prevent SSIs. An interdisciplinary team at a regional referral center in Michigan sought to reduce SSIs by improving compliance with the facility's preoperative antibiotic selection, dosing, timing, and redosing protocol. The interventions for the quality improvement project included adding the preprocedural antibiotics and doses to the master OR schedule; holding an education session for all preoperative nurses, intraoperative nurses, and anesthesia professionals; and posting a reference guide in the preoperative and intraoperative areas. Compliance with the facility's protocol for antibiotic selection, dosing, and timing significantly improved. However, SSI rates and compliance with redosing recommendations did not change significantly. The team decided to add the antibiotic order information to the master OR schedule permanently. The team plans to consider providing education sessions on administering preprocedural antibiotics outside the OR.

show abstract

Incidence and impact of surgical site infections on length of stay and cost of care for patients undergoing open procedures

Cited by 28 publications

References 38 publications

Surgical site infection outcomes of two different closed incision negative pressure therapy systems in cardiac surgery: Systematic review and meta‐analysis

Surgical site infection outcomes of two different closed incision negative pressure therapy systems in cardiac surgery: Systematic review and meta‐analysis

Closed Incision Negative Pressure Therapy versus Standard of Care in Reduction of Surgical Site Complications: A Systematic Review and Meta-analysis

A Quality Improvement Project to Increase Compliance With a Facility Protocol on Surgical Antimicrobial Prophylaxis

Contact Info

Product

Resources

About