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Does a Presurgical Antisepsis Protocol Decrease Surgical Site Infections in Young Children?

Valerie Lapp, Bertha Ben Khallouq, Dana Bentley

    AORN Journal
    |December 27, 2023
    PubMed

    Insights

    A new presurgical antisepsis protocol for pediatric surgical site infection (SSI) prevention showed no reduction in SSI rates. Infections present before surgery were the main predictor of SSIs in children.

    Area of Science:

    • Pediatric Surgery
    • Infection Control
    • Antisepsis Protocols

    Background:

    • National standards for preventing surgical site infections (SSIs) in pediatric patients are lacking.
    • Institutions are developing protocols to mitigate SSI risks in children.

    Purpose of the Study:

    • To evaluate the effectiveness of a novel presurgical antisepsis protocol in reducing SSI rates in pediatric surgical patients.
    • To identify predictors of SSI in children undergoing surgical procedures.

    Main Methods:

    • Retrospective cohort study analyzing electronic health records.
    • Inclusion of 1,356 pediatric patients aged 2-11 years undergoing surgical procedures with an incision.
    • Comparison of SSI rates before and after implementing a three-component antisepsis protocol (chlorhexidine bathing wipes, oral rinse, and povidone-iodine nasal swab).

    Main Results:

    • No statistically significant difference in SSI occurrence was observed after protocol implementation.
    • Pre-existing infections at the time of surgery were identified as the sole significant predictor of SSIs.
    • The implemented presurgical antisepsis protocol did not demonstrate an association with reduced SSI rates in the studied pediatric cohort.

    Conclusions:

    • The presurgical antisepsis protocol, combining chlorhexidine and povidone-iodine, was not associated with a reduction in surgical site infections in pediatric patients.
    • Focusing on pre-operative infection screening may be more critical for SSI prevention in this population.

    Keywords:
    bundlechlorhexidine gluconate (CHG)pediatricpresurgical antisepsis protocolsurgical site infection (SSI)

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