Safe Surgery Checklist Reduces Infections and Costs in Spine, Hip, and Knee Procedures

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Patient Safety

Background:

• Surgical site infections (SSIs) pose a significant risk in orthopedic procedures.
• The Safe Surgery Program aims to mitigate SSIs through standardized protocols.
• Evaluating the program's impact on complex procedures like spinal and joint surgeries is crucial.

Purpose of the Study:

• To assess the effectiveness of the Safe Surgery Program in reducing SSI rates.
• To analyze changes in SSI rates before and after program implementation.
• To identify risk factors and associated outcomes, including hospital costs.

Main Methods:

• A nested case-control study design was employed.
• Adult patients undergoing spinal procedures or total hip/knee arthroplasties were included.
• Cases with SSIs were matched 1:1 with controls, analyzing risk factors and adherence to the World Health Organization checklist.

Main Results:

• SSI rates decreased from 2.0% to 0.7% post-program implementation (p=0.017).
• Blood transfusion was a significant risk factor for SSI (OR=2.67, p=0.040).
• Hospital costs were lower for patients without SSIs (p=0.024), and antimicrobial use increased.

Conclusions:

• The Safe Surgery Program effectively reduced SSI incidence and hospital costs in complex orthopedic surgeries.
• Optimizing peri-operative management, particularly concerning blood transfusions, is vital.
• Adherence to surgical safety practices is key to improving patient outcomes.