Colorectal Surgical Site Infection Prevention Kits Prior to Elective Colectomy Improve Outcomes

Area of Science:

• Colorectal surgery
• Surgical quality improvement
• Infection control

Background:

• Patient compliance with preoperative protocols is crucial for Enhanced Recovery After Surgery (ERAS) and reducing surgical site infections (SSIs).
• A quality improvement project was initiated to enhance compliance using a free SSI Prevention Kit (SSIPK).

Purpose of the Study:

• To evaluate the impact of the SSIPK on patient compliance with preoperative bowel preparation.
• To assess the effect of the SSIPK on SSI rates and other postoperative complications in elective colectomy patients.

Main Methods:

• Prospective data audit comparing 221 SSIPK+ patients with 1760 historical SSIPK- controls.
• 1:1 propensity score matching to account for nonrandom treatment assignment.
• Comparison of postoperative complications, including SSIs, ileus, and hospital length of stay.

Main Results:

• SSIPK+ patients demonstrated significantly higher compliance with mechanical (95% vs 71%) and oral antibiotic (94% vs 27%) bowel preparation.
• Overall SSI rates were lower in the SSIPK+ group (5.9% vs 11.4%).
• SSIPK+ patients experienced fewer anastomotic leaks, prolonged postoperative ileus, unplanned intubations, and shorter hospital stays (3.1 vs 5.4 days), with fewer readmissions.

Conclusions:

• Providing a free SSIPK enhances patient adherence to preoperative regimens.
• The SSIPK is associated with significant reductions in SSIs, postoperative ileus, and hospital length of stay.
• Widespread adoption of such kits can substantially improve surgical outcomes.