A Standardized Perioperative Surgical Site Infection Care Process Among Children with Stoma Closure: A Before–After Study.

Autor: Porras-Hernandez, Juan, Bracho-Blanchet, Eduardo, Tovilla-Mercado, Jose, Vilar-Compte, Diana, Nieto-Zermeño, Jaime, Davila-Perez, Roberto, Teyssier-Morales, Gustavo, Lule-Dominguez, Martha
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Zdroj: World Journal of Surgery; Oct2008, Vol. 32 Issue 10, p2316-2323, 8p, 3 Charts, 1 Graph
Abstrakt: We report on the effectiveness of a standardized perioperative care process for lowering surgical site infection (SSI) rates among children with stoma closure at a tertiary-care public pediatric teaching hospital in Mexico City. All consecutive children with stoma closure operated on between November 2003 and October 2005 were prospectively followed for 30 days postoperatively. We conducted a before–after study to evaluate standardized perioperative bowel- and abdominal-wall care process results on SSI rates. Seventy-one patients were operated on, and all completed follow-up. SSI rates declined from 42.8% (12/28) before to 13.9% (6/43) after the standardization procedure (relative risk (RR) = 3.1; 95% confidence interval (CI) = 1.3–7.2; p = 0.006). SSI independently associated risk factors comprised peristomal skin inflammation >3 mm (odds ratio (OR) = 9.6; 95% CI = 1.8–49.6; p = 0.007) and intraoperative complications (OR = 13.3; 95% CI = 1.4–127.2 ; p = 0.02). Being operated on during the after-study period was shown to be a protective factor against SSI (OR = 0.2; 95% CI = 0.4–0.97; p = 0.04). Standardization was able to reduce SSI rates threefold in children with stoma closure in a short period of time. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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