Perioperative Bundle Decreases Postoperative Hepatic Surgery Infections

Area of Science:

• Hepatobiliary surgery
• Surgical infection prevention
• Evidence-based medicine

Background:

• Postoperative infections, including surgical site infections (SSIs), are significant causes of morbidity and increased healthcare costs.
• Perioperative infection prevention bundles have demonstrated success in reducing SSIs in colorectal and pancreatic surgery.
• Hepatic surgery patients are also susceptible to postoperative infectious complications.

Purpose of the Study:

• To evaluate the effectiveness of a perioperative infection prevention bundle in reducing postoperative infectious complications in patients undergoing hepatic surgery.
• To assess the impact of the bundle on surgical site infections (SSIs) and overall infection rates.
• To determine if the bundle influences postoperative length of stay (LOS).

Main Methods:

• An evidence-based, low-cost perioperative infection bundle was implemented.
• A retrospective review of a prospectively maintained database of 163 consecutive hepatic surgery patients was conducted.
• Data on patient characteristics, operative details, outcomes, and complications were analyzed, comparing pre- and post-bundle implementation using univariate and multivariate analyses.

Main Results:

• The overall infection rate decreased from 20.4% to 4%, and the SSI rate decreased from 15% to 4% post-bundle implementation.
• Multivariate analysis confirmed the bundle was independently associated with lower infection (p=0.008) and SSI (p=0.05) rates.
• Significant reductions in primary and 60-day postoperative length of stay (LOS) were observed post-bundle (median LOS decreased from 5 to 4 days, p ≤ 0.001).

Conclusions:

• Implementation of a perioperative infection prevention bundle significantly reduces overall infections and SSIs in patients undergoing hepatic surgery.
• The bundle is associated with a significant decrease in postoperative length of stay.
• This strategy offers a valuable, cost-effective method for improving outcomes in hepatic surgery patients.