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15.06.2017 | Review Article | Ausgabe 11/2017

Journal of Gastrointestinal Surgery 11/2017

Bundles Prevent Surgical Site Infections After Colorectal Surgery: Meta-analysis and Systematic Review

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 11/2017
Autoren:
Aleksander Zywot, Christine S.M. Lau, H. Stephen Fletcher, Subroto Paul
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11605-017-3465-3) contains supplementary material, which is available to authorized users.

Abstract

Introduction

Colorectal surgeries (CRS) have one of the highest rates of surgical site infections (SSIs) with rates 15 to >30%. Prevention “bundles” or sets of evidence-based interventions are structured ways to improve patient outcomes. The aim sof this study is to evaluate CRS SSI prevention bundles, bundle components, and implementation and compliance strategies.

Methods

A meta-analysis of studies with pre- and post-implementation data was conducted to assess the impact of bundles on SSI rates (superficial, deep, and organ/space). Subgroup analysis of bundle components identified optimal bundle designs.

Results

Thirty-five studies (51,413 patients) were identified and 23 (17,557 patients) were included in the meta-analysis. A SSI risk reduction of 40% (p < 0.001) was noted with 44% for superficial SSI (p < 0.001) and 34% for organ/space (p = 0.048). Bundles with sterile closure trays (58.6 vs 33.1%), MBP with oral antibiotics (55.4 vs 31.8%), and pre-closure glove changes (56.9 vs 28.5%) had significantly greater SSI risk reduction.

Conclusion

Bundles can effectively reduce the risk of SSIs after CRS, by fostering a cohesive environment, standardization, and reduction in operative variance. If implemented successfully and complied with, bundles can become vital to improving patients’ surgical quality of care.

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Zusatzmaterial
Supplement 1 (DOC 32 kb)
11605_2017_3465_MOESM1_ESM.doc
Supplement 2 (DOCX 120 kb)
11605_2017_3465_MOESM2_ESM.docx
Literatur
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