Empowering patients through a perioperative prevention bundle to reduce surgical site infections in colorectal surgery

IF 2.4 3区医学 Q2 INFECTIOUS DISEASES American journal of infection control Pub Date : 2025-04-03 DOI:10.1016/j.ajic.2025.03.151

Vladimir Nikolic MD , Ljiljana Markovic-Denic MD, PhD , Stefan Kmezic MD, PhD , Aleksandar Radovanovic MD , Djordje Nektarijevic MD , Jelena Djokic-Kovac MD, PhD , Djordje Knezevic MD, PhD , Andrija Antic MD, PhD

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Abstract

Background

Surgical site infections (SSIs) are common in colorectal surgery, with rates ranging from 5.4% to 30%. This study evaluated the impact of a perioperative prevention bundle on SSI incidence.

Methods

A prospective cohort study with a before-after analysis was conducted from April 2022 to April 2023. The intervention included patient education, preoperative and postoperative chlorhexidine bathing, and mandatory glove change before fascial closure.

Results

The implementation of the perioperative prevention bundle resulted in a significant reduction in the overall SSI rate, from 18.5% to 3.8% (P = .016). Superficial SSIs were decreased from 11.1% to 0% (P = .012), while reductions in deep and organ-space SSIs were not statistically significant. Additionally, rehospitalization rates within 30 days dropped from 14.0% to 2.0% (P = .029). The intervention achieved full compliance among patients and staff.

Discussion

The individualized approach likely contributed to high compliance, potentially enabling patients to take a more active role in their care. Further research is needed to address the challenges associated with deep and organ-space infections.

Conclusions

The implementation of a perioperative prevention bundle, emphasizing patient education and engagement, effectively reduced the incidence of SSIs and rehospitalization rates following colorectal surgery.

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通过围手术期预防束增强患者能力，减少结直肠手术手术部位感染。

背景：手术部位感染（SSI）是结直肠手术中的一种重要并发症，发生率从 5.4% 到 30% 不等。本研究旨在评估围手术期预防包对结直肠手术 SSI 发生率的影响：方法：2022 年 4 月至 2023 年 4 月进行了一项前瞻性队列研究，并进行了前后分析。干预措施包括患者教育、术前和术后洗必泰沐浴以及筋膜闭合前强制更换手套：结果：实施围手术期预防包后，总体 SSI 感染率显著下降，从 18.5% 降至 3.8%（p = 0.016）。浅层 SSI 从 11.1% 降至 0%（p = 0.012），而深层和脏器间隙 SSI 的减少无统计学意义。此外，30 天内再次住院率从 14.0% 降至 2.0%（p = 0.029）。患者和医护人员都完全遵守了干预措施：讨论：个性化方法可能有助于提高依从性，使患者在护理中发挥更积极的作用。结论：围手术期预防措施的实施有助于提高患者的依从性：实施围手术期预防捆绑计划，强调患者教育和参与，有效降低了结直肠手术后 SSI 的发生率和再住院率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)