Colorectal surgery and surgical site infection: is a change of attitude necessary?

• Published in: International journal of colorectal disease Vol. 32; no. 7; pp. 967 - 974
• Main Authors: Elia-Guedea, Manuela, Cordoba-Diaz de Laspra, Elena, Echazarreta-Gallego, Estibaliz, Valero-Lazaro, María Isabel, Ramirez-Rodriguez, Jose Manuel, Aguilella-Diago, Vicente
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2017; Springer Nature B.V
• Subjects: Aged; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Colorectal surgery; Colorectal Surgery - adverse effects; Demography; Female; Gastroenterology; Health Knowledge, Attitudes, Practice; Hepatology; Humans; Infections; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Morbidity; Original Article; Postoperative Complications - etiology; Proctology; Surgery; Surgical site infections; Surgical Wound Infection - drug therapy; Surgical Wound Infection - etiology; Colorectal surgery; Bundle of measures; Risk factor
• DOI: 10.1007/s00384-017-2801-0
• ISSN: 0179-1958

Introduction Surgical site infection (SSI) can be as high as 30% in patients undergoing colorectal surgery and is associated with an increase in morbidity and mortality. The aim of this study is to evaluate the impact of a set of simple preventive measures that have resulted in a reduction in surgical site infection in colorectal surgery. Applied method Prospective study with two groups of patients treated in the colorectal unit of the “Clinico Universitario Lozano Blesa” hospital in Zaragoza. One group was subject to our measures from February to May 2015. The control group was given conventional treatment within a time period of 3 months before the set of measures were implemented. Results One hundred forty-nine patients underwent a major colorectal surgical procedure. Seventy (47%) belonged to the control group and were compared to the remaining 79 patients (53% of the total), who were subject to our treatment bundle in the period tested. Comparing the two groups revealed that our set of measures led to a general reduction in SSI (31.4 vs. 13.6%, p  = 0.010) and in superficial site infection (17.1 vs. 2.5%, p  = 0.002). As a consequence, the postoperative hospital stay was shortened (10.0 vs. 8.0 days, p  = 0.048). However, it did not, the number of readmissions nor the re-operation rate. SSI was clearly related to open surgery. Conclusions The preventive set of measures applied in colorectal surgery led to a significant reduction of the SSI and of the length of hospital stay.