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Effective methods to decrease surgical site infections in pediatric gastrointestinal surgery

Andrew B Nordin1, Stephen P Sales2, Gail E Besner3

  • 1Nationwide Children's Hospital, Department of Pediatric Surgery, Columbus, OH; State University of New York University at Buffalo, Department of General Surgery, Buffalo, NY.

Journal of Pediatric Surgery
|November 8, 2017
PubMed

Insights

A new perioperative gastrointestinal (GI) bundle effectively reduced surgical site infection (SSI) rates in pediatric GI operations. The bundle also decreased length of stay and hospital charges for specific procedures like stoma closures.

Area of Science:

  • Pediatric Surgery
  • Infectious Disease Control
  • Healthcare Quality Improvement

Background:

  • Pediatric gastrointestinal (GI) surgeries contribute significantly to surgical site infections (SSIs), leading to increased morbidity.
  • Existing perioperative bundles show promise in reducing SSIs, but specific pediatric GI data is limited.
  • This study investigated the impact of a tailored GI bundle on SSI rates, length of stay (LOS), and hospital charges in pediatric patients.

Purpose of the Study:

  • To evaluate the effectiveness of a newly implemented perioperative GI bundle in reducing SSI rates in pediatric GI surgery.
  • To assess the impact of the GI bundle on length of stay (LOS) and hospital charges.
  • To analyze the specific effects of the bundle on different types of pediatric GI operations.

Main Methods:

  • A prospective study was conducted after establishing baseline SSI rates.
  • A comprehensive perioperative GI bundle was developed and implemented in November 2014.
  • Data collected included demographics, procedure type, LOS, charges, bundle compliance, and SSI development, analyzed using process control charts.

Main Results:

  • The overall SSI rate showed variability but ultimately decreased.
  • Significant reductions in SSI rates were observed for midgut/hindgut operations (11.3% to 8.0%) and stoma closures (21.4% to 7.9%).
  • While overall LOS and charges remained unchanged, average LOS decreased for midgut/hindgut surgeries and stoma closures, with substantial charge reduction for stoma closures.

Conclusions:

  • The implemented perioperative GI bundle successfully decreased SSI rates in pediatric GI surgery, particularly for midgut/hindgut procedures.
  • The bundle demonstrated efficacy in reducing LOS and hospital charges, most notably in stoma closure surgeries.
Abstract

Keywords:
BundleGISurgical site infection

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