Getting It Right First Time: the national survey of surgical site infection rates in NHS trusts in England

Abstract

Introduction Surgical site infections are associated with increased morbidity and mortality in patients. The Getting It Right First Time surgical site infection programme set up a national survey to review surgical site infection rates in surgical units in England. The objectives were for frontline clinicians to assess the rates of infection following selected procedures, to examine the risk of significant complications and to review current practice in the prevention of surgical site infection. Methods A national survey was launched in April 2017 to assess surgical site infections within 13 specialties: breast surgery, cardiothoracic surgery, cranial neurosurgery, ear, nose and throat surgery, general surgery, obstetrics and gynaecology, ophthalmology, oral and maxillofacial surgery, orthopaedic surgery, paediatric surgery, spinal surgery, urology and vascular surgery. All participating trusts prospectively identified and collected supporting information on surgical site infections diagnosed within the six-month study period. Results Data were received from 95 NHS trusts. A total of 1807 surgical site infection cases were reported. There were variations in rates reported by trusts across specialties and procedures. Reoperations were reported in 36.2% of all identified cases, and surgical site infections are associated with a delayed discharge rate of 34.1% in our survey. Conclusion The Getting It Right First Time surgical site infection programme has introduced a different approach to infection surveillance in England. Results of the survey has demonstrated variation in surgical site infection rates among surgical units, raised the importance in addressing these issues for better patient outcomes and to reduce the financial burden on the NHS. Much work remains to be done to improve surgical site infection surveillance across surgical units and trusts in England.

Impact of Incisional Surgical Site Infections on Quality of Life and Patient Satisfaction after General Surgery: A Case Controlled Study

“…The literature comparing deep and superficial ISSI confirm a greater cost and LOS for deep ISSI [7,11,12]. Additionally, reports that focus on ISSI have demonstrated an increase in LOS [7,[12][13][14][15] and readmissions [2,11]. In our institution, the mean increase in LOS because of ISSI after abdominal surgery was 4.4 days [16].…”

“…Surgical site infection includes superficial incisional SSI, deep incisional SSI, and space SSI [1]. Depending on the surgical procedure and how SSI is monitored, these occur in up to 20% of patients after general surgery [2][3][4][5][6]. Historical studies of SSI diagnosed in hospital report a two-fold increase in mortality, greater than five day increase in length of stay (LOS), a fivefold increase in rates of re-admission, and mean increase in costs greater than $5,000 [7,8].…”

“…The impact of incisional surgical site infection (ISSI) is more difficult to define because ISSI and space SSI are often reported as one entity [1][2][3][4][5][6][7][8]. Abdominal space infections, usually caused by enteric organisms, differ in pathophysiology and consequences from ISSI [9].…”

Infectious Complication in Relation to the Prophylactic Mesh Position: The PRIMA Trial Revisited

“…This difference could be due to poor prior cicatrisation of the linea alba after developing an IH. Furthermore, SSIs are more likely to occur in case of prior abdominal surgery (17).…”

Wound photography for evaluation of surgical site infection and wound healing after lower limb trauma

“…Deep surgical site infections (SSIs) are one of the most common and costly healthcare-associated infections, associated with prolonged hospital length of stay, morbidity, and mortality. 1,2 Postoperative SSIs are widely used as indicators of healthcare quality and are routinely captured within national and international surveillance systems. Most national, mandatory systems use Centers for Disease Control and Prevention (CDC) definitions, 2,3 or modifications of these definitions, comprising detailed diagnostic criteria for incisional superficial, deep, and organ-space SSI.…”