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Infection prevention plan to decrease surgical site infections in bariatric surgery patients.

Bradley S Kushner1,2, Dawn Freeman3, Ashley Waldrop4

  • 1Department of Surgery, Washington University, Saint Louis, USA. b.kushner@wustl.edu.

Surgical Endoscopy
|May 12, 2021
PubMed
Summary

Implementing infection prevention protocols significantly reduced surgical site infections (SSIs) after bariatric surgery. Eliminating routine drain placement was key to this success, improving patient safety in metabolic and bariatric surgery.

Keywords:
Bariatric surgeryComplications of bariatric surgerySurgical drainSurgical site infection

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Area of Science:

  • Bariatric Surgery Outcomes
  • Infection Control in Surgery
  • Quality Improvement in Healthcare

Background:

  • Surgical site infections (SSIs) are a common complication following bariatric surgery.
  • The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) promotes data-driven quality improvement.
  • Accredited centers aim to reduce adverse events like SSIs.

Purpose of the Study:

  • To decrease surgical site infection (SSI) rates in patients undergoing bariatric surgery.
  • To evaluate the effectiveness of implemented infection prevention protocols (IPPs).
  • To identify factors influencing SSI risk in bariatric procedures.

Main Methods:

  • Retrospective review of SSI rates using MBSAQIP data (2014-2015 baseline).
  • Implementation of two infection prevention protocols (IPP-1 and IPP-2) with specific interventions.
  • Analysis of perioperative factors associated with SSI risk.

Main Results:

  • Baseline SSI rate was 5.1%.
  • IPP-1 implementation reduced SSI rates to 2.5%.
  • IPP-2 implementation further decreased SSI rates to 1.5% (66% relative risk reduction).
  • Diabetes, drain placement, hypertension medications, and open approach were associated with increased SSI risk.

Conclusions:

  • Specific infection prevention protocols are safe and feasible for bariatric surgery patients.
  • Eliminating routine surgical drain placement is a critical factor in reducing SSIs.
  • Quality improvement initiatives can effectively lower complication rates in accredited bariatric surgery centers.