The “bundle” approach to reduce the surgical site infection rate

Bert, Fabrizio; Giacomelli, Sebastian; Amprino, Viola; Pieve, Giulio; Ceresetti, Daniela; Testa, Marco; Zotti, Carla Maria

doi:10.1111/jep.12694

Cited by 29 publications

(33 citation statements)

References 17 publications

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“…A key component of our initial quality improvement prospectus was the creation of interdepartmental teams to review the literature and collectively decide upon bundled interventions and their implementation. This aspect of reduction bundling is similarly supported and emphasized throughout the literature [1, 2, 11, 15]. Furthermore, the ongoing issues of compliance and monitoring are integral to the creation and success of an SSI reduction bundle program.…”

Section: Discussionmentioning

confidence: 84%

“…SSI reduction “bundling” recently has gained interest as a means of managing the complicated, multifactorial nature of SSIs [7–10]; however, results have been mixed across a range of subspecialties [11, 12]. Colorectal surgery, consistently associated with the highest SSI rates, has been particularly notable for equivocal results on SSI reduction bundling in various studies using a mixture of interventions [7, 9, 13–21].…”

Section: Introductionmentioning

confidence: 99%

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Surgical site infection reduction bundle in patients with gynecologic cancer undergoing colon surgery

Schiavone

Moukarzel

Leong

et al. 2017

Gynecologic Oncology

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Objective Surgical site infections (SSIs) can lead to substantial morbidity, prolonged hospitalization, increased costs, and death in patients undergoing colorectal procedures. We sought to investigate the effect of using an SSI reduction bundle on the rate of SSIs in gynecologic cancer patients undergoing colon surgery. Methods We identified all gynecologic cancer patients who underwent colon resection at our institution from 2014–2016, during which time a service-wide SSI reduction bundle was introduced. The intervention included preoperative oral antibiotics with optional mechanical bowel preparation, skin preparation with antibacterial solution, and the use of a separate surgical closing tray. SSI rates were assessed within 30 days post-surgery. Results Of 233 identified patients, 115 had undergone colon surgery prior to (PRE) and 118 after (POST) the implementation of the intervention. A low anterior resection was the most common colon surgery in both cohorts. The incidence of SSI within 30 days of surgery was 43/115 (37%) in the PRE and 14/118 (12%) in the POST cohorts (p≤0.001). Wound dehiscence was noted in 30/115 (26%) and 2/118 (2%) patients, respectively (p≤0.001). In patients whose operation took longer than 360 minutes, 30-day SSI rates were 37% (28/76) and 12% (8/67), respectively (p≤0.001). In patients with an estimated blood loss >500 cc, SSI rates were 44% (27/62) and 15% (10/67), respectively (p≤0.001). Conclusions The implementation of an SSI reduction bundle was associated with a significant reduction in 30-day SSIs in these patients. The intervention remained effective in patients undergoing longer operations and in those with increased blood loss.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Surgical site infection reduction bundle in patients with gynecologic cancer undergoing colon surgery

Schiavone

Moukarzel

Leong

et al. 2017

Gynecologic Oncology

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“…O desfecho infeccioso pós-cirúrgico é favorecido por uma multiplicidade de fatores inter-relacionados que abrangem diversos aspectos assistenciais do pré, trans e pósoperatório, além de envolver múltiplos fatores organizacionais e humanos, exigindo a atuação de uma equipe multiprofissional treinada e capacitada na prevenção desses eventos. Estudos demonstram que o enfermeiro tem exercido papel chave na implantação e sustentação de medidas de vigilância aos fatores de risco e na prevenção da ISC, como a implantação de bundles e da lista de verificação cirúrgica, por exemplo, ferramentas que têm contribuído para a redução significativa de ISC em diversas instituições (9)(10) .…”

Section: Introductionunclassified

Infecção do sítio cirúrgico em pacientes submetidos a cirurgias cardíacas: uma análise do perfil epidemiológico

Braz

Evangelista²,

Evangelista

et al. 2018

R. Enferm. Cent. O. Min.

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Objetivo: Descrever a ocorrência da infecção do sítio cirúrgico em pacientes submetidos à revascularização do miocárdio e/ou implante de valva cardíaca e seu perfil epidemiológico. Método: Tratou-se de estudo retrospectivo, realizado em hospital de grande porte. Os dados foram coletados nos prontuários dos pacientes de cirurgias entre 2011 e 2015. Realizou-se estatística descritiva e análise bivariada pelo Epi-info 6.4. Resultados: Foram revisados 280 prontuários de pacientes com idade média de 58 anos. As principais comorbidades encontradas nesses pacientes foram hipertensão arterial e dislipidemia, sendo comum ainda a febre reumática naqueles com implante de prótese valvar. Foram diagnosticadas 52 infecções do sítio cirúrgico, sendo 32 (61,5%) durante a internação e 20 (38,5%) por reinternação. As infecções incisionais superficiais foram prevalentes seguidas de órgão/cavidade. A idade, tempo de internação total e no pós-operatório e dias no Centro de Terapia Intensiva após a cirurgia foram associadas à ocorrência infecciosa em órgão/cavidade. O tempo médio de internação foi de 18,1 dias nos pacientes sem infecção e 25,4 naqueles com infecção. Conclusão: É imprescindível investir em medidas de prevenção de infecções que envolvem equipes assistenciais, profissionais de controle de infecção e núcleos de segurança na busca de melhores práticas assistenciais. ABSTRACT Objective:The study aimed to describe the occurrence of surgical site infection in patients submitted to myocardial revascularization and/or cardiac valve implantation as well as its epidemiological profile. Method: This was a retrospective study performed at a large hospital. Data were collected from patients' records of surgeries performed from 2011 to 2015. Descriptive statistics and bivariate analysis were performed using Epi-info 6.4. Results: We reviewed 280 patient records with a mean age of 58 years old. The main comorbidities found in those patients were arterial hypertension and dyslipidemia and, in those patients with valve prosthesis, rheumatic fever was common. Fifty-two (52) surgical site infections were diagnosed, 32 (61.5%) happening during the hospitalization and 20 (38.5%) in re-hospitalization. The superficial incisional infections were prevalent followed by organ/cavity. Age, total and post-operative hospitalization time, and days at the Intensive Care Center Unit after surgery were associated to infectious occurrence in organ/cavity. The mean time of hospitalization was 18.1 days in patients without infection and 25.4 in those with infection. Conclusion: It is imperative to invest in infection prevention measures involving care teams, infection control professionals and safety centers in the search for better care practices. RESUMENObjetivo: Describir la ocurrencia de infección del sitio quirúrgico en pacientes sometidos a revascularización del miocardio, y/o implantación de valvas y su perfil epidemiológico. Método: Fue un estudio retrospectivo en un hospital grande. Los datos fueron recopilados de las historias clínicas de los pa...

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“…Implementation of SSI care bundles has been shown to reduce SSI rates by up to 40% [68,69,[71][72][73][74]. The majority of the published studies are cohort studies.…”

Section: Arguments Against the Use Of Moabmentioning

confidence: 99%

The use of oral antibiotics and mechanical bowel preparation in elective colorectal resection for the reduction of surgical site infection

et al. 2020

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The “bundle” approach to reduce the surgical site infection rate

Abstract: The use of surgical bundle seems to reduce significantly the SSIs rate in the colon surgery.

Cited by 29 publications

References 17 publications

Surgical site infection reduction bundle in patients with gynecologic cancer undergoing colon surgery

Surgical site infection reduction bundle in patients with gynecologic cancer undergoing colon surgery

Infecção do sítio cirúrgico em pacientes submetidos a cirurgias cardíacas: uma análise do perfil epidemiológico

The use of oral antibiotics and mechanical bowel preparation in elective colorectal resection for the reduction of surgical site infection

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