Surgical site infection rate can be reduced in hysterectomy
Sarah E. Andiman, M.D., from the Yale School of Medicine in New Haven, Conn., and colleagues conducted a quality improvement study featuring a retrospective analysis of a prospectively implemented, multidisciplinary team-designed surgical site infection prevention bundle. The bundle included use of chlorhexidine-impregnated preoperative wipes, standardized aseptic surgical preparation, standardized antibiotic dosing, perioperative normothermia, and surgical dressing maintenance; when the protocol was breached, direct feedback was provided to clinicians.
During the 33-month study period, 2,099 hysterectomies were completed. The researchers found that there were 61 and 14 surgical site infections in the pre-full bundle implementation period and post-full bundle implementation period (4.51 and 1.87 percent, respectively); during the last eight months of the study period there was a sustained reduction in the proportion of patients experiencing surgical site infection. Patients who underwent surgery after full implementation were significantly less likely to develop a surgical site infection than those undergoing surgery before full implementation, after adjustment for clinical characteristics (adjusted odds ratio, 0.46).
"The multidisciplinary implementation of a gynecologic perioperative surgical site infection prevention bundle was associated with a significant reduction in surgical site infection rate in patients undergoing hysterectomy," the authors write.
One author disclosed financial ties to 3M, which markets patient warming devices, and other companies in the health care industry.
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