Measures for Prevention and Control of Surgical Site Infection

2021 ◽  
pp. 23-35
Author(s):  
Kejian Wu ◽  
Jie Sun ◽  
Xinghua Li
Keyword(s):  
Surgical Site Infection ◽  
Prevention And Control ◽  
Site Infection ◽  
And Control

scholarly journals Penerapan Metode Six Sigma dalam Pencegahan dan Pengendalian Infeksi di Rumah Sakit: A Systematic Review

2019 ◽  
Vol 11 (1) ◽  
pp. 108
Author(s):  
Waluyo Waluyo ◽  
Sholihin Sholihin ◽  
Roby Aji Permana ◽  
Tria Anisa Firmanti ◽  
Yulia Indah Permatasari
Keyword(s):  
Surgical Site Infection ◽  
Six Sigma ◽  
Prevention And Control ◽  
Blood Stream Infection ◽  
Health Sector ◽  
Decubitus Ulcer ◽  
Blood Stream ◽  
Central Line ◽  
Site Infection ◽  
And Control

Background: Prevention and control of infections is a priority in the current health sector, and prevention of infection is an indicator of the quality of services provided. Purpose: to examine the available evidence about the application of the Six Sigma method in the prevention and control of infections in hospitals. Method: The database used to identify suitable articles obtained from Scopus, Pubmed, Ebscohost and Summon was limited to the last 5 years of publication from 2014 to 2019, English, and fulltext articles. The literature review used the keyword "Six Sigma, Prevention Infection". In searching articles used "AND". Only 8 articles met the inclusion criteria. This review was from these 8 articles. Results: The application of the six sigma method provided a variety of benefits. Prevention and Reduction of decubitus ulcer infection, Central Line Related Blood Flow Infection, Surgical Site Infection, Ventilator Related Pneumonia, reduced the incidence of health related infections, reduced length of stay, increased health protection, reduced treatment costs and improved patient safety. Conclusion: the six sigma method is effective in preventing and controlling infection in hospitals. Recommendation: hospitals apply this method for approval and control of infection. Keywords: six sigma; infection; hospital ABSTRAK Latar belakang: Pencegahan dan pengendalian infeksi menjadi prioritas bidang kesehatan saat ini, dan mengurangi kejadian infeksi merupakan salah satu indikator kualitas layanan yang diberikan. Tujuan: untuk menguji bukti yang ada tentang penerapan metode six sigma dalam pencegahan maupun pengendalian kejadian infeksi di rumah sakit. Metode: database digunakan untuk mengidentifikasi artikel yang sesuai diperoleh dari Scopus, Pubmed, Ebscohost dan Summon terbatas untuk publikasi 5 tahun terakhir dari 2014 hingga 2019, bahasa inggris, dan fulltex article. Tinjauan literatur menggunakan kata kunci “ Six Sigma, Prevention Infection”. Dalam pencarian artikel menggunakan "AND". Hanya 8 artikel yang memenuhi kriteria inklusi. Ulasan ini berasal dari 8 artikel tersebut. Hasil: penerapan metode six sigma memberikan manfaat yang beragam. Pencegahan dan penurunan kejadian infeksi ulkus decubitus, Central Line Associated Blood Stream Infection, Surgical Site Infection, Ventilator Associated Pneumonia, menurunkan kejadian healthcare associated infections, mengurangi lama hari rawat, meningkatkan kepatuhan kebersihan tangan, mengurangi biaya perawatan dan meningkatkan keselamatan pasien. Simpulan: metode six sigma efektif mencegah dan mengendalikan infeksi di rumah sakit. Saran: rumah sakit menerapkan metode ini untuk pencegahan dan pengendalian infeksi Kata kunci: six sigma; infeksi; rumah sakit

scholarly journals Surgical Site Infection Prevention: An Analysis of Compliance With Good Practice in Large Hospitals

2020 ◽  
Vol 41 (S1) ◽  
pp. s396-s396
Author(s):  
Adriana Oliveira
Keyword(s):  
Surgical Site Infection ◽  
Prevention And Control ◽  
Good Practice ◽  
Prophylactic Antibiotic ◽  
Minas Gerais ◽  
Control Measures ◽  
Hair Removal ◽  
Site Infection ◽  
Hospital Infection Control ◽  
And Control

Background: Surgical site infection (SSI) is considered one of the most frequent adverse events globally. One of the strategies to mitigate its occurrence was proposed by the WHO in 2008 as part of the Safe Surgery Saves Lives program to reduce the rate of SSI by 25% by 2020. Objectives: To evaluate adherence to SSI prevention and control actions in large hospitals using a score. Methods: This cross-sectional study was conducted in 30 hospitals in Minas Gerais, Brazil, from February 2018 to April 2019. Data collection was performed through interviews with the coordinator of the hospital infection control service (HICS), situational diagnoses, and observation of a surgical procedures at the time of the visit. Data were analyzed using SPSS software. The variables were described using descriptive statistics. The project was approved by the Research Ethics Committee of the Federal University of Minas Gerais (COEP/UFMG) (CAAE: 30782614.3.00005149). A score was determined to identify the degree of compliance of institutions to SSI prevention practices. Results: In 93.3% of the HICSs, routines or protocols for the use of prophylactic antibiotic in surgery and compliance audits were mentioned, 69% reported hair removal with a clipper. SSI surveillance occurred in all institutions; however, only 63.3% disclosed SSI rates. In the situational observations, 60% of the professionals performed hand antisepsis within 3–5 minutes. Most frequently, hair removal was performed inside the operating room in 76.7% of the observed procedures and an electric clipper was used 56.7% of the time. In the surgery audit, prophylactic antimicrobial administration occurred between 30 and 60 minutes before surgical incision in only 63.3% of the observed procedures. The traffic in the operation room was limited to the necessary minimum in only 53.3% of observed procedures and unnecessary opening of the doors occurred in 76.7% of the observations. Patient temperature was not monitored in 70% of the audited procedures. Conclusions: According to the proposed score, 1 of the institutions (3.3%) complied with SSI prevention and control measures sufficiently; 25 complied partially (83.3%); and 4 (13.3%) demonstrated poor compliance.Funding: NoneDisclosures: None

scholarly journals A meta-analysis of the local application of vancomycin powder to prevent surgical site infection after spinal surgeries

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052092005
Author(s):  
Shuo Shan ◽  
Laiyong Tu ◽  
Wenfei Gu ◽  
Kahaer Aikenmu ◽  
Jiang Zhao
Keyword(s):  
Surgical Site Infection ◽  
Meta Analysis ◽  
Local Application ◽  
Site Infection ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Mesh Terms ◽  
Vancomycin Powder ◽  
Vancomycin Group ◽  
And Control

Objective This study aimed to systematically analyze the effectiveness and safety of the local application of vancomycin powder to prevent surgical site infection (SSI) after spinal surgeries and provide guidance for clinical practice. Methods Two researchers independently searched PubMed, Web of Science, Elsevier, and China National Knowledge Infrastructure using the MeSH terms “spinal surgery,” “vancomycin,” “local,” “topical,” “prophylactic,” “surgical site infection,” and “SSI” to identify studies published between January 2010 and January 2020 on the local application of vancomycin powder for preventing SSI after spinal surgeries. The outcome assessment indicators were analyzed using RevMan 5.3 software. Results Three randomized controlled trials, two prospective studies, and 26 retrospective studies were included in the current research. The results of the meta-analysis revealed significant differences between the vancomycin and control groups (non-vancomycin group) concerning the incidence of SSI (risk ratio = 0.39, 95% confidence interval = 0.28–0.55, Z = 5.46), indicating that local application of vancomycin powder can significantly reduce the incidence of SSI. Conclusion Local application of vancomycin powder is an effective and safe method to prevent SSI after spinal surgeries.

scholarly journals A systematic review and meta-analysis of randomized controlled trials for the reduction of surgical site infection in closed incision management versus standard of care dressings over closed vascular groin incisions

Vascular ◽  
2020 ◽  
Vol 28 (3) ◽  
pp. 274-284 ◽  
Author(s):  
Alexander Gombert ◽  
Ellen Dillavou ◽  
Ralph D’Agostino ◽  
Leah Griffin ◽  
Julie M Robertson ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Surgical Site Infection ◽  
Meta Analysis ◽  
Site Infection ◽  
Infection Rates ◽  
Control Groups ◽  
Randomized Controlled ◽  
Risk Patients ◽  
Meta Analyses ◽  
And Control

Objective Surgical site infection after groin incision is a common complication and a financial burden to patients and healthcare systems. Closed incision negative pressure therapy (ciNPT) has been associated with decreased surgical site infection rates in published literature. This meta-analysis examines the effect of ciNPT (PREVENA™ Incision Management System; KCI, San Antonio, TX) versus traditional postsurgical dressing use in reducing surgical site infection rates over closed groin incisions following vascular surgery. Methods A systematic literature search using PubMed, OVID, EMBASE, and QUOSA was performed on 3 January 2019, by two independent researchers and focused on publications between 1 January 2005 and 31 December 2018. The review conformed to the statement and reporting check list of the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Inclusion criteria included abstract or manuscript written in English, published studies, conference abstracts, randomized controlled trials (RCTs), ciNPT usage over closed groin incisions in vascular surgery, comparison of ciNPT use and traditional dressings, study endpoint/outcome of surgical site infection, and study population of >10. Characteristics of study participants, surgical procedure, type of dressing used, duration of treatment, incidence of surgical site infection, and length of follow-up were extracted. Weighted odds ratios and 95% confidence intervals were calculated to pool study and control groups in each publication for analysis. Treatment effects were combined using Mantel-Haenszel risk ratios, and the Chi-Square test was used to assess heterogeneity. Overall, high-risk patients, normal-risk patients, and Szilagyi I, II, III outcomes were assessed between ciNPT and control groups. The Cochrane Collaboration tool was utilized to assess the risk of bias for all studies included in the analysis. Results A total of 615 articles were identified from the literature search. After removal of excluded studies and duplicates, six RCT studies were available for analysis. In these studies, a total of 362 patients received ciNPT, and 371 patients received traditional dressings (control). Surgical site infection events occurred in 41 ciNPT patients and 107 control patients. The heterogeneity test was nonsignificant ( p > 0.05). The overall RCT meta-analysis showed a highly significant effect in favor of ciNPT (OR = 3.06, 95% CI [2.05, 4.58], p < 0.05). High-risk, normal-risk, Szilagyi I, and Szilagyi II meta-analyses were also statistically significant in favor of ciNPT use ( p < 0.05). The varying RCT inclusion/exclusion criteria, such as differences in procedure types, and patient populations form the major limitations of this study. Conclusions A statistically significant reduction in the incidence of surgical site infection was seen following ciNPT usage in patients undergoing vascular surgery with groin incisions.

scholarly journals Role of subcutaneous closed vacuum drain in preventing surgical site infection in emergency surgery for perforative peritonitis: A randomized control study

2017 ◽  
Vol 16 (1) ◽  
pp. 85-90 ◽  
Author(s):  
Sanjeev Kumar ◽  
Souvik Chatterjee ◽  
Shahana Gupta ◽  
Ayusman Satpathy ◽  
Shamita Chatterjee ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Categorical Variables ◽  
Site Infection ◽  
Randomized Control Study ◽  
Closed Suction ◽  
Perforative Peritonitis ◽  
Drain Group ◽  
Randomized Control ◽  
And Control ◽  
Control Study

Objective: The aim of our study was to evaluate whether insertion of a subcutaneous closed suction vacuum drain at incisional surgical site reduces the incidence of surgical site infection (SSI) in post operative cases of exploratory laparotomy for perforative peritonitis.Methods: An institutional based randomized control study was performed with two hundred patients each included in the study (with drain) and control (without drain) group. Both groups were statistically similar in terms of various variables and thus comparable. All continuous variables were reported as mean ± SD and compared across groups using unpaired t-test. All categorical variables were reports as n (%) compared across groups using Chi-square test for independence of attributes.Result: Use of a subcutaneous closed suction vacuum drain results in statistically significant reduction in wound infection (58% vs 16%; p < 0.001). The most common organism causing SSI was found to be Escherichia Coli accounting for 62.5% and 62.7% of cases in drain group and control group respectively, followed by Klebsiella (12.5% vs 24.14%).Conclusion: Use of a subcutaneous closed suction vacuum drain is effective in reducing SSI in contaminated surgery like that for perforative peritonitis and also leads to reduction in SSI related complications like wound disruption, patient discomfort, bad cosmesis, prolonged hospital stay, antibiotic use and increased cost.Bangladesh Journal of Medical Science Vol.16(1) 2017 p.85-90

scholarly journals The role of antimicrobial sutures in preventing surgical site infection

2017 ◽  
Vol 99 (6) ◽  
pp. 439-443 ◽  
Author(s):  
D Leaper ◽  
P Wilson ◽  
O Assadian ◽  
C Edmiston ◽  
M Kiernan ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Perioperative Period ◽  
Infection Prevention And Control ◽  
Site Infection ◽  
Skin Preparation ◽  
Life Threatening ◽  
Level I ◽  
The Uk ◽  
Healthcare Associated ◽  
And Control

INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient’s pathway through both nosocomial and community care. METHODS This report is based on a meeting held at The Royal College of Surgeons of England on 21 July 2016. Using PubMed, members of the panel reviewed the current use of antiseptics and antimicrobial sutures in their specialties to prevent SSI. FINDINGS The group agreed that wider use of antiseptics in surgical practice may help in reducing reliance on antibiotics in infection prevention and control, especially in the perioperative period of open elective colorectal, hepatobiliary and cardiac operative procedures. The wider use of antiseptics includes preoperative showering, promotion of hand hygiene, (including the appropriate use of surgical gloves), preoperative skin preparation (including management of hair removal), antimicrobial sutures and the management of dehisced surgical wounds after infection. The meeting placed emphasis on the level I evidence that supports the use of antimicrobial sutures, particularly in surgical procedures after which the SSI rate is high (colorectal and hepatobiliary surgery) or when a SSI can be life threatening even when the rate of SSI is low (cardiac surgery).

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