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Colorectal surgery and surgical site infection: is a change of attitude necessary?

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Introduction

Surgical site infection (SSI) can be as high as 30% in patients undergoing colorectal surgery and is associated with an increase in morbidity and mortality. The aim of this study is to evaluate the impact of a set of simple preventive measures that have resulted in a reduction in surgical site infection in colorectal surgery.

Applied method

Prospective study with two groups of patients treated in the colorectal unit of the “Clinico Universitario Lozano Blesa” hospital in Zaragoza. One group was subject to our measures from February to May 2015. The control group was given conventional treatment within a time period of 3 months before the set of measures were implemented.

Results

One hundred forty-nine patients underwent a major colorectal surgical procedure. Seventy (47%) belonged to the control group and were compared to the remaining 79 patients (53% of the total), who were subject to our treatment bundle in the period tested. Comparing the two groups revealed that our set of measures led to a general reduction in SSI (31.4 vs. 13.6%, p = 0.010) and in superficial site infection (17.1 vs. 2.5%, p = 0.002). As a consequence, the postoperative hospital stay was shortened (10.0 vs. 8.0 days, p = 0.048). However, it did not, the number of readmissions nor the re-operation rate. SSI was clearly related to open surgery.

Conclusions

The preventive set of measures applied in colorectal surgery led to a significant reduction of the SSI and of the length of hospital stay.

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References

  1. Hennessey DB, Burke JP, Ni-Dhonochu T, Shields C, Winter DC, Mealy K (2016) Risk factors for surgical site infection following colorectal resection: a multi-institutional study. Int J Color Dis 31(2):267–271

    Article  Google Scholar 

  2. Owens CD, Stoessel K (2008) Surgical site infections: epidemiology, microbiology and prevention. J Hosp Infect England 70(Suppl 2):3–10

    Article  Google Scholar 

  3. Keenan JE, Speicher PJ, Thacker JKM, Walter M, Kuchibhatla M, Mantyh CR (2014) The preventive surgical site infection bundle in colorectal surgery: an effective approach to surgical site infection reduction and health care cost savings. JAMA Surg 149(10):1045–1052

    Article  PubMed  Google Scholar 

  4. Chen M, Song X, Chen L-Z, Lin Z-D, Zhang X-L (2016) Comparing mechanical bowel preparation with both oral and systemic antibiotics versus mechanical bowel preparation and systemic antibiotics alone for the prevention of surgical site infection after elective colorectal surgery: a meta-analysis of randomize. Dis Colon rectum 59(1):70–78

  5. Tanner J, Padley W, Assadian O, Leaper D, Kiernan M, Edmiston C (2015) Do surgical care bundles reduce the risk of surgical site infections in patients undergoing colorectal surgery? A systematic review and cohort meta-analysis of 8,515 patients. Surgery 158(1):66–77

    Article  PubMed  Google Scholar 

  6. Biondo S (2014) Prevention of surgical site infection: still an important challenge in colorectal surgery. Tech Coloproctol 18(10):861–862

    Article  CAS  PubMed  Google Scholar 

  7. Kirchhoff P, Clavien P-A, Hahnloser D (2010) Complications in colorectal surgery: risk factors and preventive strategies. Patient Saf Surg [Internet] 4(1):5 Available from:http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2852382&tool=pmcentrez&rendertype=abstract

    Article  Google Scholar 

  8. Badía JM, Pérez J (2016) Medidas específicas de prevención de la infección de sitio quirúrgico. In: Guía Clínica de Infecciones Quirúrgicas de la Asociación Española de Cirujanos, pp 151–174

    Google Scholar 

  9. Perez-Blanco V, Garcia-Olmo D, Maseda-Garrido E, Najera-Santos MC, Garcia-Caballero J (2015) Evaluation of a preventive surgical site infection bundle in colorectal surgery. Cir Esp 93(4):222–228

    Article  PubMed  Google Scholar 

  10. Connolly TM, Foppa C, Kazi E, Denoya PI, Bergamaschi R (2016) Impact of surgical site infection reduction strategy after colorectal resection. Color Dis 18(9):910–918. doi:10.1111/codi.13145

    Article  CAS  Google Scholar 

  11. Mallol M, Sabaté A, Kreisler E, Dalmau A, Camprubi I, Trenti L et al (2012) Incidencia de la infección de la herida quirúrgica en cirugía colorrectal electiva y su relación con factores perioperatorios. Cir Esp 90(6):376–381

    Article  PubMed  Google Scholar 

  12. Park YY, Kim CW, Park SJ, Lee KY, Lee JJ, Lee HO et al (2015) Influence of shorter duration of prophylactic antibiotic use on the incidence of surgical site infection following colorectal cancer surgery. Ann Coloproctol 31(6):235–242

    Article  PubMed  PubMed Central  Google Scholar 

  13. Kim EK, Sheetz KH, Bonn J, DeRoo S, Lee C, Stein I et al (2014) A statewide colectomy experience. Ann Surg 259(2):310–314

    Article  PubMed  Google Scholar 

  14. Scarborough JE, Mantyh CR, Sun Z, Migaly J (2015) Combined mechanical and oral antibiotic bowel preparation reduces incisional surgical site infection and anastomotic leak rates after elective colorectal resection. Ann Surg 262(2):331–337

    Article  PubMed  Google Scholar 

  15. Huttner B, Robicsek AA, Gervaz P, Perencevich EN, Schiffer E, Schrenzel J et al (2012) Epidemiology of methicillin-resistant Staphylococcus aureus carriage and MRSA surgical site infections in patients undergoing colorectal surgery: a cohort study in two centers. Surg Infect (Larchmt) [Internet] 13(6):401–405 Available from: http://www.scopus.com/inward/record.url?eid=2-s2.084871636256&partnerID=tZOtx3y1\n http://www.scopus.com/inward/record.url?eid=2-s2.0-84871636256&partnerID=40&md5=440ed3a60d2774d663739b1f63772bb8

    Article  Google Scholar 

  16. Tanner J, Kiernan M, Hilliam R, Davey S, Collins E, Wood T et al (2016) Effectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery. Ann R Coll Surg Engl England 98(4):270–274

    Article  CAS  Google Scholar 

  17. Ghuman A, Chan T, Karimuddin AA, Brown CJ, Raval MJ, Phang PT (2015) Surgical site infection rates following implementation of a colorectal closure bundle in elective colorectal surgeries. Dis Colon rectum 58(11):1078–1082

  18. Kumar S, Leaper D Classification and management of acute wounds. Classif Manag acute wounds Surg-Oxford Int Ed 23(2):47–51

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Authors and Affiliations

  1. Colorectal Department, University Hospital of Zaragoza, San Juan Bosco Avenue, 15, 50009, Zaragoza, Spain

    Manuela Elia-Guedea, Elena Cordoba-Diaz de Laspra, Estibaliz Echazarreta-Gallego, María Isabel Valero-Lazaro, Jose Manuel Ramirez-Rodriguez & Vicente Aguilella-Diago

  2. Instituto de Investigaciones Sanitarias de Aragon (IIS), Zaragoza, Spain

    Manuela Elia-Guedea, Elena Cordoba-Diaz de Laspra, Estibaliz Echazarreta-Gallego, Jose Manuel Ramirez-Rodriguez & Vicente Aguilella-Diago

Authors
  1. Manuela Elia-Guedea
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  2. Elena Cordoba-Diaz de Laspra
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  3. Estibaliz Echazarreta-Gallego
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  4. María Isabel Valero-Lazaro
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  5. Jose Manuel Ramirez-Rodriguez
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  6. Vicente Aguilella-Diago
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Corresponding author

Correspondence to Estibaliz Echazarreta-Gallego.

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Elia-Guedea, M., Cordoba-Diaz de Laspra, E., Echazarreta-Gallego, E. et al. Colorectal surgery and surgical site infection: is a change of attitude necessary?. Int J Colorectal Dis 32, 967–974 (2017). https://doi.org/10.1007/s00384-017-2801-0

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  • DOI: https://doi.org/10.1007/s00384-017-2801-0

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