Rochester, Minn.-based Mayo Clinic researchers found a surgical site infection reduction bundle greatly lowered the risk of a SSI, according to Medscape Specialty.
Researchers studied SSIs in patients who had staging laparotomy for uterine cancer, ovarian cancer debulking without bowel resection or ovarian cancer debulking with bowel resection.
During the preintervention period, researchers assessed the SSI rates retrospectively among 635 patients who underwent one of the three surgeries between Jan. 1, 2010 and Dec. 31, 2012. The SSI reduction bundle had a patient education pamphlet on SSI prevention techniques, which included Hibiclens shower before surgery, prophylactic antibiotic administration, coverage of the incisional area with ChloraPrepand and cefazolin redose within 3 hours to 4 hours post incision.
In the intervention period, researchers added new elements to the SSI bundle for 190 patients. The new elements included sterile closing tray and staff glove change for fascia and skin closure, dressing removal at 24 hours to 48 hours, discharge with 4 percent chlorhexidine gluconate and a follow-up telephone call from a nurse within 24 hours to 72 hours.
Here are six findings:
1. Among patients with ovarian cancer without bowel resection, the overall SSI rate fell from 4.8 percent to 1 percent.
2. Among patients who underwent ovarian cancer surgery with bowel resection, the SSI rate fell from 10.6 percent to 2.4 percent.
3. The SSI rate for patients who underwent hysterectomy for uterine cancer dropped from 5.1 percent to 0 percent.
4. Researchers found the superficial incisional SSI relative risk reduction was 100 percent.
5. The relative risk reduction for organ and space SSI was 73.3 percent.
6. In the study, only two deep incisional SSIs occurred. Such SSIs occurred in ovarian cancer patients who did not undergo bowel resection in the preintervention group.
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