Surgical site infection prevention care bundles in colorectal surgery: a scoping review.

Abstract

Background: Surgical site infection preventions bundles have been used to reduce infection rate in most types of surgery. In colorectal surgery they have been used with success as well, with tailored care bundles designed for that purpose.

Aim: To identify and review the individual interventions that constitute each infection prevention care bundle in colorectal surgery, and the surgical site infection rate reduction related to their implementation.

Methods: A scoping review was conducted in PUBMED, CINAHL; Web of Science Core Collection and Scopus databases, during December 2022.

Results: This review analysed 48 of 164 identified studies on surgical site infection (SSI) prevention in colorectal surgery from 2011 to 2022. It revealed an average of 11 interventions per study, primarily in preoperative (mechanical bowel preparation, oral antibiotic bowel decontamination, hair removal, CHG showers, normoglycemia), intraoperative (antibiotic prophylaxis, normothermia, CHG skin preparation, antibiotic prophylaxis re-dosing, gown/glove change), and postoperative phases (normothermia, normoglycemia, dressing removal, oxygen optimization, incision cleansing). Despite these interventions, SSI rates remain high, indicating a need for further research to optimize intervention bundles and improve compliance across surgical stages.

Conclusions: The implementation of Surgical Site Infection prevention bundles, tailored to Colorectal surgery, have shown a reduction in surgical site infection rates and costs. Grouping intervention according to the perioperative phase, may contribute to increased compliance rates.