Implementation of an abdominal closure bundle to reduce surgical site infection in patients on a gynecologic oncology service undergoing exploratory laparotomy

Bruce, Shaina F.; Carr, Danielle; Burton, Elizabeth R.; Sorosky, Joel I.; Shahin, Mark S.; Naglak, Mary; Edelson, Mitchell I.

doi:10.1016/j.ygyno.2018.03.045

Cited by 10 publications

(2 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many studies have shown their effectiveness in significantly reducing SSI [ 25 , 26 ]. One study implementing a bundle in a similar patient population to ours (gynecological oncology patients undergoing an exploratory laparotomy) did not show any significant effect in the overall incidence of SSI, but did in those with more advanced malignancy [ 27 ]. It could be that ciNPWT may have a role to play as a postoperative component of such a bundle in a select subset of gynecological oncology patients.…”

Section: Discussionmentioning

confidence: 91%

Closed-Incision Negative Pressure Wound management Following Midline Laparotomy in Gynecological Oncology Operations: A Feasibility Pilot Study

Yin¹,

Lau²,

Mehra³

et al. 2021

Cureus

View full text Add to dashboard Cite

IntroductionSurgical site infections (SSIs) are a cause of considerable morbidity and mortality in healthcare. Increasingly, closed-incision negative pressure wound therapy (ciNPWT) is being studied as a potential method of reducing incidence of SSI with conflicting results in the literature. Few studies however have looked at its use in the field of gynecological oncology. ObjectivesWe aimed to compare the incidence of SSI when using ciNPWT dressings versus conventional dressings in gynecological oncology patients undergoing midline laparotomies. MethodsThis was a pilot study involving 14 patients receiving the ciNPWT dressing and 26 control patients. All patients were followed up for a period of 30 days. We used the American College of Surgeons (ACS) risk calculator to estimate each patient's risk of SSI in order to risk stratify the groups. ResultsThe incidence of wound infection was 21% (3/14) in the ciNPWT group and 23% (6/26) in the control group (p=0.886). The ciNPWT group was found to be at significantly higher risk for SSI as calculated by the ACS tool (8.8% ciNPWT, 6% control, p=0.004). After stratifying for this difference in risk, still no significant difference in incidence of SSI was found between the two groups (27% (3/11) ciNPWT, 29% (2/7) control p=0.929). ConclusionThe incidence of SSI does not appear to decrease by the prophylactic use of the closed-incision negative pressure wound dressing.

show abstract

Section: Discussionmentioning

confidence: 91%

Closed-Incision Negative Pressure Wound management Following Midline Laparotomy in Gynecological Oncology Operations: A Feasibility Pilot Study

Yin¹,

Lau²,

Mehra³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…SSI has a significant impact on the emotional well‐being of patients and their families and can increase the length of hospital stay and health care expenditure 10 . Our understanding of SSI prevention bundles predominantly stems from gynecological and colorectal surgeries 11,12 . The Greater New York Hospital Association (GNHYA) has proposed a standardized comprehensive perioperative abdominal surgery bundle to support internal quality improvement efforts at various NY institutions 13 .…”

Section: Introductionmentioning

confidence: 99%

Decreased incidence of cesarean surgical site infection rate with hospital‐wide perioperative bundle

Sood

Lee

et al. 2021

Birth

View full text Add to dashboard Cite

Background Reduction in the incidence of surgical site infection (SSI) serves as a measure of patient safety and quality improvement. Cesarean birth (CB) accounts for 31.9% of all childbirths in the United States. However, our understanding of SSI prevention bundles predominantly stems from gynecological and colorectal surgeries. This study aimed to determine the efficacy of a standardized perioperative bundle designed to reduce SSI in CBs. Methods All CB patients at Flushing Hospital Medical Center from 2017 to 2019 were included in a retrospective analysis. Patients were divided into three groups based on the timing of intervention: prebundle/control, transition, and postbundle. Baseline demographics and clinical characteristics were summarized using descriptive statistics. Multiple logistic regression was performed to determine the association between bundle group and SSI, considering variables different between groups at baseline (P < 0.10). Results Two thousand eight hundred and seventy‐five CBs were performed: 1086 in prebundle, 812 in transition, and 977 in postbundle phase. In the prebundle phase, 25 CBs (2.3%) were complicated by SSIs; in the transition phase, 10 (1.2%) had SSIs; and in the postbundle phase, 7 (0.7%; P = 0.009) had SSIs. In a logistic regression model, only use of the CB bundle (OR 0.26 [95% CI 0.07‐0.94]; P = 0.04), rupture of membranes (0.29 [0.09‐0.87]; P = 0.03), and operating room time (1.02 [1.01‐1.04]; P = 0.01) were significant in prediction of SSI. SSI postbundle was significantly reduced from prebundle (0.04). Conclusions Thus, introduction of a hospital‐wide perioperative bundle significantly reduced SSI rates, and should be developed as a mainstay of CB surgical care.

show abstract

A bundled intervention lowers surgical site infection in hysterectomy for benign and malignant indications

Guo

Runge

Miller

et al. 2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

Implementation of an abdominal closure bundle to reduce surgical site infection in patients on a gynecologic oncology service undergoing exploratory laparotomy

Cited by 10 publications

References 27 publications

Closed-Incision Negative Pressure Wound management Following Midline Laparotomy in Gynecological Oncology Operations: A Feasibility Pilot Study

Closed-Incision Negative Pressure Wound management Following Midline Laparotomy in Gynecological Oncology Operations: A Feasibility Pilot Study

Decreased incidence of cesarean surgical site infection rate with hospital‐wide perioperative bundle

A bundled intervention lowers surgical site infection in hysterectomy for benign and malignant indications

Contact Info

Product

Resources

About