Rates of Surgical-Site Infection: An International Comparison

2005 ◽  
Vol 26 (5) ◽  
pp. 442-448 ◽  
Author(s):  
Maria Luisa Moro ◽  
Filomena Morsillo ◽  
Marilena Tangenti ◽  
Maria Mongardi ◽  
Maria Cristina Pirazzini ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Prospective Study ◽  
Surgical Site Infections ◽  
Public Hospitals ◽  
Operative Procedures ◽  
Surgical Patients ◽  
Site Infection ◽  
Italian Region ◽  
Convenience Sample ◽  
Study Population

AbstractObjectives:To quantify the occurrence of surgical-site infections (SSIs) in an Italian region and to estimate the proportion of potentially avoidable infections through benchmarking comparison.Design:Prospective study during 1 month based on a convenience sample of surgical patients admitted to 31 public hospitals. All of the patients undergoing an intervention included among the 44 operative procedures of the National Nosocomial Infections Surveillance (NNIS) System were enrolled. Ninety-five percent of the patients were actively observed after discharge for up to 30 days for all of the operations and for up to 1 year for operations involving implantation.Results:Among the 6,167 operative procedures studied, 290 infections were recorded (4.7 per 100 procedures), 206 (71%) of which were SSIs (3.3 per 100 procedures; 95% confidence interval, 2.9–3.9). One hundred thirty-five SSIs (65.5%) were superficial infections, 53 (25.7%) were deep infections, and 12 (5.8%) were organ–space infections; in 6 cases (2.9%), the type of SSI was not recorded. The frequency of SSIs observed in this study was significantly higher for several procedures than that expected when the NNIS System rates (standardized infection ratio [SIR] ranging from 1.77 to 6.42) or the Hungarian rates (SIR ranging from 1.28 to 3.04) were applied to the study population.Conclusions:The high intensity of postdischarge surveillance can in part explain the differences observed. To allow for meaningful benchmarking comparison, in addition to intrinsic patient risk, data on the intensity of postdischarge surveillance should be included in published reports.

scholarly journals Impact of the Health Transformation Plan on the Number of Surgical Operations and Their Cancelation

2019 ◽  
Vol 56 ◽  
pp. 004695801984638
Author(s):  
MahmoodReza Miri Bonjar ◽  
Mohammad Khammarnia ◽  
Mahdie Bakhshi ◽  
Alireza Ansari-Moghaddam ◽  
Hassan Okati–Aliabad ◽  
...  
Keyword(s):  
Health Insurance ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Outpatient Service ◽  
Public Hospitals ◽  
Inpatient Service ◽  
Treatment Needs ◽  
Study Population ◽  
The Impact ◽  
Surgical Operations

Operation cancelations are a serious problem with undesirable consequences. The Health Transformation Plan was launched in the health system of Iran on May 5, 2014, to enhance the efficiency and quality of services in public hospitals. Comprehensive coverage of patients’ basic treatment needs and reduction of patients’ out-of-pocket expenditures through insurance for all are other objectives of Health Transformation Plan as well. Then, the present study aimed to determine the impact of the Health Transformation Plan on the number of surgical operations and the cancelation of elective surgeries within public hospitals of Iran. This retrospective comparative study was conducted in 2017 within 2 tertiary public hospitals in the South-East of Iran. Using systematic random sampling method and census, 8138 scheduled surgical files and all canceled operations files were reviewed from April 2012 to March 2017, respectively. A standard checklist was used for data collection. The data were analyzed using χ2 test and a logistic regression model in SPSS, version 21. The study population was 8138 patients with mean age of 33 ± 19 years. Female patients comprised about 51% of the study population (n = 4115), and nearly two-third of them were married (n = 5192 [63.79%]). Coverage by Iranian health insurance was reported in more than half of patients (n = 4415 [54.79%]). The common reason for surgeries was injury and poisoning (n = 2814 [34.52%]) followed by delivery (n = 1747 [21.46%]). The number of operations increased from 26 677 before Health Transformation Plan (cancelation rate = 1.5%) to 33 190 after Health Transformation Plan (cancelation rate = 2.0%). The cancelation rate had a significant relationship with age (odds ratio = 1.009; confidence interval: 1.00-1.01), health insurance status (odds ratio = 2.12; confidence interval: 1.33-3.38), outpatient service referrals (odds ratio = 0.5; confidence interval: 0.43-0.62), inpatient service referrals (odds ratio = 1.5; confidence interval: 1.36-1.77), and surgical types ( P < .05). In general, the Health Transformation Plan was markedly associated with a rise in the number of surgeries and cancelation rate in the public hospitals. The information obtained in the present study concerning the causes of operation cancelations can be used to decrease the number of future cancelations.

scholarly journals Novel Closing Method Using Subcutaneous Continuous Drain for Preventing Surgical Site Infections in Radical Cystectomy

ISRN Urology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Yasuhiko Hirose ◽  
Taku Naiki ◽  
Ryosuke Ando ◽  
Akihiro Nakane ◽  
Toshiki Etani ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Confidence Interval ◽  
Radical Cystectomy ◽  
Dead Space ◽  
Odds Ratio ◽  
Wound Dressing ◽  
Subcutaneous Fat ◽  
Surgical Site Infections ◽  
New Method ◽  
Site Infection

To reduce the incidence of surgical site infection (SSI) after radical cystectomy, a new closing method using subcutaneous continuous aspiration drain was developed and compared to the conventional closing method. The new method involved (a) closed aspiration with an indwelling aspiration drain without suture of the subcutaneous fat and (b) covering with hydrocolloid wound dressing after suture of the dermis with 4-0 absorbable thread and reinforcement using strips. The incidence of SSI was significantly improved by using the new method. Furthermore, univariate and multivariate analysis associated with SSI revealed that the new closing method was statistically correlated with 85% reduction of SSI (odds ratio: 0.15, 95% confidence interval: 0.03–0.69).Our new method using continuous aspiration with subcutaneous drain is useful for preventing SSI through removal of effusions and reduction of dead space by apposition of the subcutaneous fat.

Surgical Site Infections in Abdominal Surgeries - A Clinicopathological Prospective Study

2021 ◽  
Vol 8 (02) ◽  
pp. 69-74
Author(s):  
Biswaranjan Mohapatra ◽  
Dipesh Kumar Padhihari ◽  
Mrutynjay Das ◽  
Sai Barath Sunkara ◽  
Saikh Kasif Sahajada
Keyword(s):  
Prospective Study ◽  
Surgical Site Infection ◽  
Medical Science ◽  
Operating Time ◽  
Surgical Techniques ◽  
Surgical Site Infections ◽  
Purulent Discharge ◽  
Site Infection ◽  
Group A ◽  
Group B

BACKGROUND Surgical site infection still remains a nightmare for most surgeons even in these times despite many advances in medical science, surgical techniques & better operating room environment. Surgical site infection (SSI) is defined as ‘an infection occurring within 30 days of a surgery (or within 1 year if an implant is left in place after procedure) and affecting either incision or deep tissues at the operation site. METHODS A single observer, cross sectional, prospective study was carried out in the Dept. of General Surgery, in collaboration with Microbiology & Pathology Departments of Hi-tech Medical College and Hospital, Bhubaneswar, Odisha. The study included all patients who underwent laparotomy during the period of study, patients of all age groups except neonates and patients with post-operative surgical site infections. RESULTS The prospective study involved culture and sensitivity of 114 patients undergoing clean-contaminated surgeries (group A), contaminated-surgeries (group B) in the Department of Surgery at our institute. The study shows that the maximum number of cases were between 21 to 60 yrs. of age. (78 %) and the mean age in the group A was 39.2 years while in group B, it was 39.8 years. There was a total of 90 patients between 21 - 60 yrs. of age. Mean hospital stay in group A was 5.7 days and group B was 8.9 days. The sex ratio is quite evenly matched, 63 male patients and 51 female patients out of 114 cases. Amongst the 114 subjects, group A comprised of 58.77 % (67) while group B consisted of 41.22 % (47.13) patients. Out of 67, 13 from group A came back as sterile, in group B sterile samples were 10. CONCLUSIONS This study concludes that age, sex, class of wound, peri-operative management, operating time and co-morbidities of the patient, all have a significant effect on the incidence of surgical site infections. KEYWORDS Surgical Site Infection, Laparotomy, Purulent Discharge, Drain

scholarly journals Negative Pressure Incision Management System in the Prevention of Groin Wound Infection in Vascular Surgery Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Jan H. Koetje ◽  
Karsten D. Ottink ◽  
Iris Feenstra ◽  
Wilbert M. Fritschy
Keyword(s):  
Vascular Surgery ◽  
Negative Pressure ◽  
Surgical Site Infections ◽  
Surgical Patients ◽  
Management Systems ◽  
Wound Infections ◽  
Site Infection ◽  
Surgical Wound ◽  
Postoperative Wound ◽  
Emergency Procedures

Objectives. Groin wounds following vascular surgery are highly susceptible to healing disturbances, with reported site infections reaching 30%. Negative pressure incision management systems (NPIMS) are believed to positively influence the prevention of surgical wound-healing disturbances (WHD) and surgical site infections (SSI). NPIMS placed directly after closure of the surgical wound is thought to result in fewer infections; we analysed its effect on postoperative wound infections in patients after vascular surgery via the groin.Methods. From May 2012 to March 2013 we included 90 surgical patients; 40 received a NPIMS. All patients with WHDs were labelled and subanalysed for surgical site infection in case of positive microbiological culture. These infections were graded according to Szilagyi. Number of WHDs and SSIs were compared across cohorts.Results. Patient and perioperative characteristics were equal, except for a significantly higher number of emergency procedures among non-NPIMS patients. We found no significant differences in number of WHDs, SSIs, or Szilagyi grades between the two cohorts.Conclusion. The equal number of SSIs across cohorts showed that NPIMS could not reduce the number of surgical site infections after vascular groin surgery.

scholarly journals Post cesarean section surgical site infection and associated factors among women who delivered in public hospitals in Harar city, Eastern Ethiopia: A hospital-based analytic cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253194
Author(s):  
Tsegaw Alemye ◽  
Lemessa Oljira ◽  
Gelana Fekadu ◽  
Melkamu Merid Mengesha
Keyword(s):  
Confidence Interval ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Site Infection ◽  
Sectional Study ◽  
Cross Sectional ◽  
Eastern Ethiopia ◽  
Factors Associated

Background Cesarean section (CS) is often complicated by surgical site infection (SSI) that may happen to a woman within 30 days after the operation. This study was conducted to estimate the prevalence of SSI and identify the factors associated with SSI. Methods A hospital-based analytic cross-sectional study was conducted based on the review of medical records of 1069 women who underwent CS in two public hospitals in Harar city. The post-CS SSI is defined when it occurred within 30 days after the CS procedure. Factors associated with SSI were identified using a multivariable binary logistic regression analysis. The analysis outputs are presented using an adjusted odds ratio (aOR) with a corresponding 95% confidence interval (CI). All statistical tests are defined as statistically significant at P-values<0.05. Results The prevalence of SSI was 12.3% (95% confidence interval (CI): 10.4, 14.4). Emergency-CS was conducted for 75.9% (95% CI: 73.2, 78.3) of the women and 13.2% (95% CI: 11.3, 15.4) had at least one co-morbid condition. On presentation, 21.7% (95% CI: 19.3, 24.3) of women had rupture of membrane (ROM). Factors significantly and positively associated with post-CS SSI include general anesthesia (aOR = 2.0, 95%CI: 1.10, 2.90), ROM (aOR = 2.27, 95%CI: 1.02, 3.52), hospital stay for over 7 days after operation (aOR = 3.57, 95%CI: 1.91, 5.21), and blood transfusion (aOR = 4.2, 95%CI: 2.35, 6.08). Conclusion The prevalence of post-CS SSI was relatively high in the study settings. Screening for preoperative anemia and appropriate correction before surgery, selection of the type of anesthesia, close follow-up to avoid unnecessary prolonged hospitalization, and careful assessment of membrane status should be considered to avoid preventable SSI and maternal morbidity.

Reduction of Surgical Site Infection Rates Associated With Active Surveillance

2006 ◽  
Vol 27 (12) ◽  
pp. 1347-1351 ◽  
Author(s):  
C. Brandt ◽  
D. Sohr ◽  
M. Behnke ◽  
F. Daschner ◽  
H. Rüden ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Confidence Interval ◽  
Surgical Site Infection ◽  
Odds Ratio ◽  
Surveillance System ◽  
Operative Procedure ◽  
Operative Procedures ◽  
Site Infection ◽  
Multiple Logistic Regression ◽  
Regression Analyses

Objective.To evaluate whether surgical site infection (SSI) rates decrease in surgical departments as a result of performing active SSI surveillance.Design.Retrospective multiple logistic regression analyses.Setting.A group of 130 surgical departments of German hospitals participating in the Krankenhaus Infektions Surveillance System (KISS).Methods.Data for 19 categories of operative procedures performed between January 1997 and June 2004 were included (119,114 operations). Active SSI surveillance was performed according to National Nosocomial Infections Surveillance system (NNIS) methods and definitions. Departments' SSI rates were calculated individually for each year of surveillance and for each operative procedure category, taking into account when the individual departments had begun their surveillance activities. Multiple logistic regression analyses on a single operation basis were carried out with stepwise variable selection to predict outcomes for patients with SSI. The variables included were as follows: the department's year of participation, NNIS risk index variables, patients' age and sex, and the hospitals' structural characteristics, such as yearly operation frequency, number of beds, and academic status.Results.For 14 of 19 operative procedure categories analyzed, there was a tendency toward lower SSI rates that was associated with increasing duration of SSI surveillance. In multiple logistic regression analyses of pooled data for all operative procedures, the departments' participation in the surveillance system was a significant independent protective factor. Compared with the surveillance year 1, the SSI risk decreased in year 2 (odds ratio, 0.84; 95% confidence interval, 0.77-0.93) and in year 3 (odds ratio, 0.75; 95% confidence interval, 0.68-0.82), and there was no change in year 4.Conclusion.The SSI incidence was reduced by one quarter as a result of the surveillance-induced infection control efforts, which indicates the usefulness of a voluntary surveillance system.

Wound care

2016 ◽  
Author(s):  
Patricia Davies
Keyword(s):  
Wound Dressing ◽  
Wound Care ◽  
Surgical Site Infections ◽  
Surgical Patients ◽  
Wound Infections ◽  
Site Infection ◽  
Secondary Intention ◽  
Wound Assessment ◽  
Healing Wound ◽  
Operative Assessment

It is imperative that the surgical nurse has a good understanding of wound care, as all surgical patients will have a wound of some description. Prevention of surgical site infection begins with a pre-operative assessment and continues post-operatively with the assessment of the wound dressing and the surgical site. This chapter discusses the physiology of wound healing, wound assessment, and dressings for primary- and secondary-intention wounds. This chapter also outlines the prevention of surgical site infections, and common wound infections and their treatment.

scholarly journals Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

2015 ◽  
Vol 49 (5) ◽  
pp. 767-774 ◽  
Author(s):  
Adriana Cristina de Oliveira ◽  
Camila Sarmento Gama
Keyword(s):  
Prospective Study ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
University Hospital ◽  
Site Infection ◽  
Surgical Team ◽  
Surgical Incision ◽  
Surgical Gloves ◽  
Glove Perforation ◽  
Belo Horizonte

AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7%) had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on 27.7% of patients in the operating room, with the use of blades in 80% of the cases. Antibiotic prophylaxis was administered to 81.8% of patients up to 60 minutes prior to surgical incision. An average of nine professionals were present during surgery and the surgery room door remained open in 94.4% of the procedures.CONCLUSIONPartial adhesion to the recommended measures was identified, reaffirming a need for greater attention to these critical steps/actions in order to prevent surgical site infection.

Enhancing recovery: Joining the Improving Surgical Care and Recovery programme to decrease colorectal surgical site infections

2021 ◽  
pp. 175045892096202
Author(s):  
Bernadette Boalt-Watson ◽  
Cherif Boutros
Keyword(s):  
Length Of Stay ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Mechanical Bowel Preparation ◽  
Surgical Care ◽  
Surgical Site Infections ◽  
The United States ◽  
Surgical Patients ◽  
Site Infection ◽  
Surgical Site Infection Rate

Aim Surgical site infections after colorectal surgery are a clinical and financial challenge in healthcare. The purpose of this project was to decrease the rate of surgical site infections in colorectal surgical patients in a community hospital with an academic cancer centre in the United States of America. Method The Quality Improvement Department obtained data to measure the hospital’s performance with colorectal surgical patients. The data examined the surgical site infection rate and the length of stay. A multidisciplinary team was established to implement protocols to improve compliance. Results More than 200 patients received a colorectal surgical resection at the hospital. The implemented protocols decreased both the surgical site infection rate and the length of stay (9.1–0% and median 6–4 days respectively). Discussion Challenges with implementation of the Improving Surgical Care and Recovery programme, in a community setting, are discussed. The challenges were worked through collaboratively to achieve the best outcomes for the patients. Conclusion The interdisciplinary committee used evidence-based practices to enhance the care of the colorectal patients. Some of the protocols that emerged were: patient education, pain medication, mechanical bowel preparation and antibiotics, as well as early alimentation. The protocols are discussed in Tables 1 to 4.

Menstruation Among Adolescent Girls Living in Rural Border Areas

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Ritu Gupta ◽  
Ravinder K Gupta ◽  
Vallabh Dogra ◽  
Himani Badyal
Keyword(s):  
Abdominal Pain ◽  
Menstrual Cycle ◽  
Blood Loss ◽  
Prospective Study ◽  
Adolescent Girls ◽  
Common Side Effect ◽  
Age Group ◽  
Different Types ◽  
Study Population ◽  
Border Areas

Objective: To study the various beliefs and problems regarding menstruation among adolescent girls living in rural border areas. Design- Prospective study. Setting- Pediatric outpatient clinic. Materials and methods- About 200 adolescent girls (11-19 years) living in rural border areas were enrolled for the study. These girls were asked about menarche, duration of the cycle, amount of blood loss and the various menstrual problems. They were also asked about the various beliefs and myths regarding menstruation. The girls having any illness affecting the menstrual cycle or those suffering from neuropsychiatric disorders were excluded from this study. Results- About 51% of the study population was in the age group 17-18 years. About 43.5% of girls attained menarche at the age of 10-12 years. About 51% of girls did not know about menstruation before menarche. Abdominal pain was the most common side effect seen in 41% of girls during menstruation. About 61% of girls considered themselves unclean during menstruation.  Twenty percent avoided schools, 20% avoided kitchen, 12% avoided temples while 10% stayed away from friends/ relatives. Only 33% of girls knew that menstruation stops temporarily after becoming pregnant. Twenty-two percent girls were using sanitary napkins while the rest used different types of clothes during the menstrual cycle. Conclusion- There is a dire need to educate girls regarding menstruation before menarche in the rural border areas. Every mother should discuss in a friendly way regarding various aspects of menstruation.

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