Surgical site infection reduction bundle in patients with gynecologic cancer undergoing colon surgery Journal Article

   


Authors: Schiavone, M. B.; Moukarzel, L.; Leong, K.; Zhou, Q. C.; Afonso, A. M.; Iasonos, A.; Long Roche, K.; Leitao, M. M. Jr; Chi, D. S.; Abu-Rustum, N. R.; Zivanovic, O.
Article Title: Surgical site infection reduction bundle in patients with gynecologic cancer undergoing colon surgery
Abstract: Objective Surgical site infections (SSIs) can lead to substantial morbidity, prolonged hospitalization, increased costs, and death in patients undergoing colorectal procedures. We sought to investigate the effect of using an SSI reduction bundle on the rate of SSIs in gynecologic cancer patients undergoing colon surgery. Methods We identified all gynecologic cancer patients who underwent colon resection at our institution from 2014 to 2016, during which time a service-wide SSI reduction bundle was introduced. The intervention included preoperative oral antibiotics with optional mechanical bowel preparation, skin preparation with antibacterial solution, and the use of a separate surgical closing tray. SSI rates were assessed within 30 days post-surgery. Results Of 233 identified patients, 115 had undergone colon surgery prior to (PRE) and 118 after (POST) the implementation of the intervention. A low anterior resection was the most common colon surgery in both cohorts. The incidence of SSI within 30 days of surgery was 43/115 (37%) in the PRE and 14/118 (12%) in the POST cohorts (p ≤ 0.001). Wound dehiscence was noted in 30/115 (26%) and 2/118 (2%) patients, respectively (p ≤ 0.001). In patients whose operation took longer than 360 min, 30-day SSI rates were 37% (28/76) and 12% (8/67), respectively (p ≤ 0.001). In patients with an estimated blood loss > 500 cm3, SSI rates were 44% (27/62) and 15% (10/67), respectively (p ≤ 0.001). Conclusions The implementation of an SSI reduction bundle was associated with a significant reduction in 30-day SSIs in these patients. The intervention remained effective in patients undergoing longer operations and in those with increased blood loss. © 2017 Elsevier Inc.
Keywords: adult; aged; aged, 80 and over; middle aged; retrospective studies; incidence; risk factors; retrospective study; risk factor; genital neoplasms, female; total quality management; surgery; colon; female genital tract tumor; quality improvement; surgical wound infection; complication; very elderly; humans; human; female
Journal Title: Gynecologic Oncology
Volume: 147
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2017-10-01
Start Page: 115
End Page: 119
Language: English
DOI: 10.1016/j.ygyno.2017.07.010
PUBMED: 28734498
PROVIDER: scopus
PMCID: PMC5605426
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85024883563&doi=10.1016%2fj.ygyno.2017.07.010&partnerID=40&md5=cc1d987073ac4a1092f4d4d0bba46218
Notes: Article -- Export Date: 1 November 2017 -- Source: Scopus
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MSK Authors
  1. Dennis S Chi
    707 Chi
  2. Mario Leitao
    575 Leitao
  3. Nadeem Abu-Rustum
    888 Abu-Rustum
  4. Oliver Zivanovic
    291 Zivanovic
  5. Qin Zhou
    253 Zhou
  6. Alexia Elia Iasonos
    362 Iasonos
  7. Kara Long Roche
    247 Long Roche
  8. Maria B Schiavone
    12 Schiavone
  9. Anoushka Maria Afonso
    47 Afonso
  10. Lea Moukarzel
    40 Moukarzel
  11. Kam Peng Leong-Sze
    3 Leong-Sze
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