A Protocol-Driven Reduction in Surgical Site Infections After Colon Surgery

Area of Science:

• Surgical quality improvement
• Infection control in surgery
• Colorectal surgery outcomes

Background:

• Surgical site infection (SSI) is a critical indicator of surgical quality and patient outcomes.
• Despite various strategies, optimal protocols for SSI reduction remain unclear.
• This study assessed the impact of an established protocol on SSI rates in colon surgery.

Purpose of the Study:

• To evaluate the effectiveness of a comprehensive SSI bundle in reducing surgical site infections after colon surgery.
• To compare SSI rates, hospital length of stay, and readmission rates before and after protocol implementation.

Main Methods:

• A colon-specific SSI bundle was implemented, including chlorhexidine prescrub, betadine wound wash, antibiotic irrigation, closure tray use, and silver-impregnated dressings.
• A retrospective analysis compared patients undergoing elective colon surgery in 2016 (preprotocol) and 2017 (postprotocol).
• Propensity score matching was used to control for demographic and clinical variables between the two groups.

Main Results:

• After propensity matching, 47 patients were in the preprotocol group and 47 in the postprotocol group.
• The postprotocol group showed significantly lower rates of superficial and deep SSI.
• Postprotocol patients experienced a shorter hospital length of stay and a trend towards lower readmission rates.

Conclusions:

• Protocol-driven care, specifically the SSI bundle, demonstrably improves patient outcomes in colon surgery.
• Standardizing care through national SSI bundles can optimize patient outcomes and reduce infection rates.
• The implemented SSI bundle led to an 85% reduction in the standardized infection rate.