Monday, May 7, 2018

Reducing Surgical Site Infections: From Global to Local.

Two recent article published in Lancet Infectious Diseases are worth noting.

This paper published by the GlobalSurg Collaborative highlights the disparities in surgical site infection (SSI) rates for gastrointestinal surgery across high, middle and low income countries. Low income counties have a disproportionate burden of SSIs, many (36%) with bacteria resistant to perioperative antibiotics.

What can be done?

This manuscript , published in the same edition of Lancet Infectious Diseases, reports the success of a surgical infection prevention bundle in 4 hospitals across 3 African nations. The bundle included perioperative bathing, avoiding hair removal, surgical hand preparation, patient skin preparation, optimal antibiotic prophylaxis and improved operating room discipline (number of people in OR, room entries etc). Compliance with these measures are reported in table 2 of the manuscript.  The bundled intervention resulted in a 60 % SSI reduction across all sites.

At VCU Health, we employ an SSI risk reduction program under the umbrella of Enhanced Recovery After Surgery (ERAS), lead by Dr. Michael Scott, as previously posted on this blog. Following ERAS implementation, our SSI rate in colorectal surgery has significantly decreased and was presented at SHEA Spring 2018 (Portland, Oregon). 

The manuscript is in process so stay tuned.

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