Surgical site infection prevention bundle for children submitted to cardiac surgery

Abstract

Objective: To build and validate the content and appearance of a surgical site infection prevention bundle for children submitted to cardiac surgery. Method: Methodological study in two phases: 1) Bundle construction from an integrative literature review from which interventions have been extracted to compose the instrument; 2) Bundle content and appearance validation by 24 judges. Results: The 24 found articles presented 17 interventions for surgical site infection prevention in this population. Out of them, seven intervention proposals have been chosen to compose the bundle and sent for assessment by judges. The final proposal includes all the seven items chosen in the construction phase and has achieved a content validity index over 0.8 in all items referring to content and appearance. Conclusion: The content and appearance of the developed bundle proposes care for the prevention of surgical site infection throughout the perioperative period.

Fatores de Risco para Infecção do Sítio Cirúrgico Pós Cirurgia Cardíaca Pediátrica

“…É proposto a adoção de bundles , ou conjunto de medidas, que contenham aquelas mais relevantes para prevenção de infecção; são estas: otimização do estado nutricional no pré-operatório, uso correto da antibioticoprofilaxia, o preparo da pele com clorexidina, a troca de luvas pelo cirurgião após esternotomia e antes do fechamento do esterno, o controle glicêmico no pré, intra e pós operatório, a cobertura estéril da ferida operatória por 48 hs, e, por fim, a redução de outras infecções nosocomiais. 2 , 3 , 12 …”

“…These bundles involve optimization of nutritional status pre-operatively, correct use of antibiotic prophylaxis, preparation of the skin with chlorhexidine, change of gloves by the surgeon after sternotomy and before closing the sternum, glycemic control pre-, intra- and post-operatively, sterile coverage of the surgical wound for 48 hours, and, finally, the reduction of other nosocomial infections. 2 , 3 , 12 …”

“…These bundles involve optimization of nutritional status preoperatively, correct use of antibiotic prophylaxis, preparation of the skin with chlorhexidine, change of gloves by the surgeon after sternotomy and before closing the sternum, glycemic control pre-, intra-and post-operatively, sterile coverage of the surgical wound for 48 hours, and, finally, the reduction of other nosocomial infections. 2,3,12 Understanding these risk factors and adopting preventive measures is essential to improve results in pediatric cardiac surgery and to reduce the incidence of infectious complications. DOI: https://doi.org/10.36660/abc.20240015…”