Collaborative Program Cuts Colorectal Sx Site Infections
(HealthDay News) – Implementation of a collaborative quality improvement program correlates with a >60% reduction in surgical site infections for patients undergoing colorectal procedures, according to a report published online Nov. 28 by the Cedars-Sinai Medical Center in Los Angeles.
From March 2011–March 2012, surgeons, nurses, operating room staff, and patients from Cedars-Sinai collaborated in a quality improvement program in an effort to reduce surgical site infections.
According to the report, the new approach included several modified or optimized processes. The evening and the morning before surgery, patients used chlorhexidine antiseptic solution in the shower. Immediately before surgery, operative sites were prepared with sterile chlorhexidine and alcohol antiseptic solution, and chlorhexidine wipes were used daily after surgery. Standardized antibiotics from a short list were used immediately before surgery, and a second dose was administered for long operations. To reduce contamination of the skin when handling intestines, use of wound protectors was encouraged. After completing the contaminated portion of the colorectal procedure, new gowns, gloves, and instruments were used by the surgical team, and operative sites were re-draped with sterile covers. In some cases of wounds considered at high risk of infection, fluids trapped in wounds were released daily. Implementation of these procedures correlated with a more than 60% drop in the postoperative surgical site infection rate, from 15% at baseline to <5% within six months, and remained <5% through July 2012.
"We are very pleased with the results we were able to achieve," Cedars-Sinai's Shirin Towfigh, MD, said in a statement. "Our work illustrates that, with institutional collaboration and low-cost changes in practice, surgeons can dramatically reduce their patients' surgical site infections."