A BUNDLE INCLUDING ORAL ANTIBIOTICS AND MECHANICAL BOWEL PREPARATION REDUCES SURGICAL SITE INFECTIONS IN ELECTIVE COLORECTAL SURGERY. PRAGMATIC COHORT STUDY
نویسندگان
چکیده
Abstract Introduction The efficacy of perioperative bundled interventions implemented at a multicenter level has been poorly studied. Methods A colorectal 6-element prevention bundle (antibiotic prophylaxis, oral antibiotic prophylaxis (OAP), mechanical bowel preparation (MBP), laparoscopy, normothermia, and wound retractor), introduced in 61 hospitals, was analysed. Surgical site infection (SSI) rates were compared before (G1, 2011–2016), after (G2, 2016–2020) the implementation. Results 37849 procedures included. 5462 overall SSI (14.43%), 2838 (7.5%) organ-space (O/S-SSI) detected. decreased from 18.38% to 10.62% with application (OR 0,503). Similarly, O/S-SSI diminished 9.15% (G1) 5.72% (G2), OR 0.602. Compared previous year, by 23% first year 29.26% SSIs diagnosed post-discharge. 54.5% required readmission. reduction similar between high, medium low volume hospitals. Overall 16.71%, when no measure applied, 6.23% all 6 implemented. Lack increased probability 3.020) 1.556). In univariate analysis, measures except normothermia associated decrease SSI, while only laparoscopy OAP for O/S-SSI. Multivariate analysis confirmed that OAP, protectors but had an effect on Conclusions preventive O/S elective colon rectal surgery. 1.5 3 times higher than
منابع مشابه
Mechanical bowel preparation for elective colorectal surgery.
BACKGROUND The presence of bowel contents during surgery has been related to anastomotic leakage, but the belief that mechanical bowel preparation (MBP) is an efficient agent against leakage and infectious complications is based on observational data and expert opinions only. OBJECTIVES To determine the security and effectiveness of MBP on morbidity and mortality in colorectal surgery. SEAR...
متن کاملRole of oral antibiotics for prophylaxis against surgical site infections after elective colorectal surgery
Over the past few decades, surgeons have made many attempts to reduce the incidence of surgical site infections (SSI) after elective colorectal surgery. Routine faecal diversion is no longer practiced in elective colonic surgery and mechanical bowel preparation is on the verge of being eliminated altogether. Intravenous antibiotics have become the standard of care as prophylaxis against SSI for...
متن کاملThe use of mechanical bowel preparation in elective colorectal surgery
BACKGROUND Mechanical bowel preparation (MBP) prior to elective colorectal surgery has been in use for many years. It is considered important in preventing post-operative infectious complications after colorectal surgery. The evidence to support these claims is lacking within the medical literature and yet this still remains standard practice in many hospitals. A literature search was undertake...
متن کاملPAPERS OF THE 135TH ASA ANNUAL MEETING Combined Preoperative Mechanical Bowel Preparation With Oral Antibiotics Significantly Reduces Surgical Site Infection, Anastomotic Leak, and Ileus After Colorectal Surgery
Objectives: To clarify whether bowel preparation use or its individual components [mechanical bowel preparation (MBP)/oral antibiotics] impact specific outcomes after colorectal surgery. Methods: National Surgical Quality Improvement Program–targeted colectomy data initiated in 2012 capture information on the use/type of bowel preparation and colorectal-specific complications. For patients unde...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
ژورنال
عنوان ژورنال: British Journal of Surgery
سال: 2023
ISSN: ['1365-2168', '0007-1323']
DOI: https://doi.org/10.1093/bjs/znac443.031