The burden of surgical site infections in Australia: A cost-of-illness study

Cocksedge, Ruth; Gillespie, Brigid M.; Chaboyer, Wendy; Byrnes, Joshua; Nghiem, S. V.

doi:10.1016/j.jiph.2023.03.018

Cited by 15 publications

(4 citation statements)

References 23 publications

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“…Surgical site infections remain a significant health problem that costs more than 320 million dollars in developed countries [ 10 ]. However, the cost can vary greatly depending on the incidence rate from country to country, which can lead to higher costs in lower-income countries.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Post-appendectomy Surgical Site Infection in Laparoscopy and Laparotomy - Retrospective Cohort Study

Fayraq,

Alzahrani,

Alsayaf Alghamdi

et al. 2023

Cureus

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Background Appendicitis is a frequent emergency condition. Surgical site infections (SSI) are a common complication of appendectomy. Despite improvements in infection control, SSIs continue to cause harm, prolonged hospital stays, and even death. Objective The objective of this study is to compare the risk of developing surgical site infections (SSIs) between open laparotomy and laparoscopic appendectomies in Al-Baha, Saudi Arabia. Methods This retrospective cohort study compared laparotomy and laparoscopy for post-operative surgical site infection among patients who underwent an appendectomy at King Fahad Hospital (KFH) in Albaha, Saudi Arabia. Medical record numbers (MRNs) of patients who met the inclusion criteria were collected to build the sampling frame. From the final sampling frame, simple random sampling using a random number generator was used to draw a representative sample. Data were collected from the surgical health records of the patients. The collected data included patients' demographics, comorbidities, presenting symptoms, ordered imaging studies, pre-operative shaving, type and duration of surgery, intraoperative findings, and signs of wound inflammation. Results The total number of patients included in the analysis was 256, who underwent surgery for acute appendicitis. Among those who underwent laparoscopy, 5.7% had to be converted to open laparotomy. Signs of surgical wound inflammation were found in 10.2% of the patients. Patients who underwent open laparotomy had a significantly higher risk of wound infection (RR=3.1, p-value=0.001). Further analysis revealed an effect modification of pre-operative shaving. Open laparotomy has a higher risk of wound infection among patients who have not had pre-operative shaving (RR=4.1 vs. RR=2.6), while both risks were statistically significant (p-value=0.033 and p-value=0.035), respectively. Complicated cases in intra-operative findings were found to have a higher risk of post-appendectomy SSI. Conclusion This study demonstrates that laparoscopic appendectomy carries a lower risk of surgical site infection (SSI) compared to open laparotomy. Additionally, pre-operative shaving of the surgical site was found to increase the incidence of SSI. Healthcare providers can use this information to enhance their practice and reduce the occurrence of surgical site infections. Whenever possible, laparoscopic appendectomy should be preferred over open laparotomy due to its substantially lower SSI risk. We also recommend vigilant monitoring of complicated appendectomy, particularly in cases of ruptured appendicitis, for signs of SSI.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Post-appendectomy Surgical Site Infection in Laparoscopy and Laparotomy - Retrospective Cohort Study

Fayraq,

Alzahrani,

Alsayaf Alghamdi

et al. 2023

Cureus

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“… 14 , 15 While postoperative care is crucial, it is the practices and protocols implemented in the operating room that lay the groundwork for successful surgical outcomes and SSI prevention. 16 , 17 This study emphasises the potential of targeted nursing interventions at this stage to significantly reduce the incidence of SSIs, which is less explored in current literature compared to postoperative care measures.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the effectiveness of proactive perioperative nursing strategies on the prevention of surgical site infections and the enhancement of skin healing in paediatric abdominal surgery

Yao,

Xi,

Duan

2024

International Wound Journal

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The present study aimed to investigate the comparative efficacy of proactive perioperative nursing interventions versus conventional perioperative nursing care in improving wound healing, reducing the incidence of surgical site infections (SSIs) and enhancing patient satisfaction among paediatric patients undergoing elective open abdominal surgery. A total of 100 paediatric patients were enrolled in a randomised controlled trial at our hospital between January 2021 and December 2022. Inclusion criteria were patients aged <18 years who met the requirements for surgical intervention and had no contraindications to surgery or anaesthesia. Patients were randomly assigned to either an observation group receiving proactive perioperative nursing care, or a control group subjected to conventional care. Primary outcome measures included surgical incision healing grades (A, B, C), infection rates confirmed by bacterial culture within 30 days post‐surgery, patient satisfaction scores and length of hospital stay. Comprehensive statistical analyses were performed using IBM's SPSS software (version 27.0). Both groups demonstrated statistically similar baseline demographics and surgical parameters. However, the observation group showed significant improvement in wound healing outcomes (Grade A) and decreased incidence of complications (Grade C) and infections compared to the control group (P < 0.05). Patient satisfaction was significantly higher in the observation group, with 80% of patients reporting satisfaction as opposed to 20% in the control group (p < 0.05). The distribution of pathogenic bacteria in SSIs predominantly included Escherichia coli (E. coli), Pseudomonas aeruginosa, Enterococcus spp., Staphylococcus aureus and Klebsiella pneumoniae. Proactive perioperative nursing interventions demonstrate considerable benefits in improving wound healing, reducing surgical site infection rates and enhancing patient satisfaction in elective open abdominal surgery settings. However, these results require validation through large‐scale trials.

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“…Surgical site infections (SSIs) are one of the most common and preventable health-care associated infections [1,2]. Globally, it is estimated that there are approximately 313 million surgical procedures undertaken each year, with an increasing demand, notably for Low-Middle Income Countries [3].…”

Section: Introductionmentioning

confidence: 99%

“…When SSIs are not prevented, they contribute to significant health and financial burden to the patient and healthcare system [1,8–10]. Therefore, it is essential for current evidence-based strategies to be implemented correctly to optimise patient care and minimise risks to patient safety…”

Section: Introductionmentioning

confidence: 99%

Surgical site infection prophylaxis: what have we learned and are we making progress?

Ierano,

Hall,

James

2023

Current Opinion in Infectious Diseases

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Purpose of review This review aims to discuss the current state of surgical antimicrobial prophylaxis (SAP) evidence for surgical site infection prevention. Despite decades of research, knowledge gaps persist in identifying optimal SAP regimens. Recent findings Recent randomised controlled trials highlight ongoing heterogeneity in study design. Key new findings support the use of oral preoperative SAP for colorectal surgery and advise against the use of SAP for transperineal prostate biopsy. There is growing evidence for culture-based SAP over empiric use for transrectal prostate biopsy. Contentious issues remain regarding topical antimicrobials for cardiac procedures involving sternotomy, the necessity of SAP for wire lumpectomy and laparoscopic cholecystectomy for both mild or moderate acute cholecystitis. Procedures where SAP is not indicated, yet research is still being conducted on this topic include dental implants and clean orthopaedic procedures. Summary Research efforts continue with numerous trials published and registered to determine optimal SAP regimens. However, many efforts are suboptimal due to poor statistical design and redundant questions already answered by existing literature. To improve practice and influence surgeons prescribing behaviour future RCTs should be well powered, with large sample sizes across multiple sites, focusing on clinically relevant questions.

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The burden of surgical site infections in Australia: A cost-of-illness study

Cited by 15 publications

References 23 publications

Risk Factors for Post-appendectomy Surgical Site Infection in Laparoscopy and Laparotomy - Retrospective Cohort Study

Risk Factors for Post-appendectomy Surgical Site Infection in Laparoscopy and Laparotomy - Retrospective Cohort Study

Evaluating the effectiveness of proactive perioperative nursing strategies on the prevention of surgical site infections and the enhancement of skin healing in paediatric abdominal surgery

Surgical site infection prophylaxis: what have we learned and are we making progress?

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