Evaluation of a Preventive Surgical Site Infection Bundle in Colorectal Surgery
| Autor: | Juan García-Caballero, Damián García-Olmo, Emilio Maseda-Garrido, María Cruz Nájera-Santos, Verónica Pérez-Blanco |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Colon Colon surgery Diabetes mellitus Humans Surgical Wound Infection Medicine Cumulative incidence Prospective Studies Digestive System Surgical Procedures Aged business.industry Rectum General Engineering Perioperative Antibiotic Prophylaxis medicine.disease Colorectal surgery Surgery Cohort Female business Surgical site infection Patient Care Bundles Historical Cohort |
| Zdroj: | Cirugía Española (English Edition). 93:222-228 |
| ISSN: | 2173-5077 |
| DOI: | 10.1016/j.cireng.2014.12.016 |
| Popis: | Objective To assess the effectiveness of a protocol for the prevention of surgical site infection (SSI) in colorectal surgery. Patients and methods Evaluation of 2 cohorts of patients undergoing colon and rectal surgery in a tertiary public hospital: A historical cohort (2008–2011) and a prospective one (after the implementation of the programme in 2012). The main measures established were: Adequacy of preoperative antimicrobial prophylaxis, maintaining patient normothermia and appropriate glove change during the intervention. Comparability of the two cohorts was determined by a bivariate analysis of age, sex, NNIS index, ASA index, surgical time, perioperative transfusion, diagnosis, diabetes and renal failure. Results We assessed 342 patients (256 underwent colon surgery and 86 rectal surgery), divided into 2 cohorts: prior period (218), and post-implementation period (124). The cumulative incidence of SSI in the first cohort was 27.5% (95% CI, 21.6–33.4), and in the post-intervention cohort 16.9% (95% CI, 10.3–23.5, P =.03). Postoperative mortality was 9.2% (95% CI, 5.4–13) in the first cohort and 3.2% (95% CI, 0.1–6.3) in the post-intervention cohort ( P =.04). The inadequacy of prophylaxis decreased from 37.4% (95% CI, 30.4–44.6) to 18.9% (95% CI, 11.9–26.1) ( P =.001). Conclusion A significant decrease in the frequency of SSI, post-surgical mortality and inadequate antimicrobial prophylaxis is verified after the implementation of a protocol in colorectal surgery |
| Databáze: | OpenAIRE |
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