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Cir Esp. 2015 Apr;93(4):222-8. doi: 10.1016/j.ciresp.2014.12.003. Epub 2015 Jan 23.

Evaluation of a preventive surgical site infection bundle in colorectal surgery.

[Article in English, Spanish]

Author information

1
Servicio de Medicina Preventiva, Hospital Universitario La Paz, Madrid, España. Electronic address: vperezb@salud.madrid.org.
2
Servicio de Cirugía General, Hospital Universitario La Paz, Madrid, España.
3
Servicio de Anestesia y Reanimación, Hospital Universitario La Paz, Madrid, España.
4
Servicio de Medicina Preventiva, Hospital Universitario La Paz, Madrid, España.

Abstract

OBJECTIVE:

To assess the effectiveness of a protocol for 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 program 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.

KEYWORDS:

Cirugía colorrectal; Colorectal surgery; Infección de localización quirúrgica; Mortalidad postoperatoria; Postoperative mortality; Surgical site infection

PMID:
25619453
DOI:
10.1016/j.ciresp.2014.12.003
[Indexed for MEDLINE]

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