Reducing Surgical Site Infection in Pediatric Scoliosis Surgery: A Multidisciplinary Improvement Program and Prospective 4-Year Audit

Tipper, Geoffrey; Chiwera, Lillian; Lucas, J.

doi:10.1177/2192568219868200

Cited by 17 publications

(18 citation statements)

References 31 publications

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“…Dentre os artigos incluídos neste estudo, um é de autoria de enfermeiros, ambos com experiência nos cuidados perioperatórios, com publicação na revista de práticas perioperatórias 11 ; um publicado em uma revista de enfermagem clínica, sem descrição do grau de instrução dos autores 12 e quatro de autoria de médicos, docentes e discentes do curso de medicina. Destes um de autoria de médico com especialização em neurocirurgia, publicado em uma revista multidisciplinar 13 ; um publicado em revista multidisciplinar por autoria de docentes e discentes do departamento de anestesiologia de um hospital escola 14 ; um publicado em uma revista sobre cirurgia, por autores do departamento de anestesia de uma faculdade de medicina 15 e um de autoria de médico com atuação no departamento de anestesia e cuidados intensivos 16 .…”

Section: Resultsunclassified

“…Os estudos selecionados foram desenvolvidos tanto no período pré-operatório 15 como no intraoperatório em salas cirúrgicas 14 , bem como em salas de recuperação anestésica 16 . Em três artigos, a auditoria foi realizada com pacientes em todo o período perioperatório [12][13]15 .…”

Section: Resultsunclassified

“…As ações relacionadas ao processo de auditoria nas unidades de centro cirúrgico, descritas neste estudo, consistem na avaliação de variáveis clínicas e também nas Brazilian Journal of Development, Curitiba, v.7, n.4, p. 41673-41688 apr 2021 relacionadas ao processo de trabalho. Como variáveis clínicas auditadas, nota-se a coleta dessas em prontuários e em entrevistas com pacientes [12][13]15 .…”

Section: Resultsunclassified

“…Estudo de auditoria realizado no Reino Unido, avaliou um grupo de 233 pacientes com doenças idiopáticas e neuromusculares, com taxa de infecção de sítio cirúrgico de 1,9% e 2,5%, em período igual a três meses, respectivamente 13 . Os achados equivaleram 16 Avaliar a possibilidade de garantir assistência pós anestésica de acordo com os padrões internacionais de qualidade e segurança na ausência de Unidade de recuperação pós-anestésica.…”

Section: Discussionunclassified

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Ações de auditoria de enfermagem em centro cirúrgico: revisão integrativa da literatura / Nursing audictory actions in surgery room: an integrative review of literature

Neves¹,

Oliveira²,

Aroni³

et al. 2021

BJDV

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O processo de auditoria de enfermagem é considerado essencial para a qualidade e os resultados nos centros cirúrgicos. O objetivo deste estudo foi analisar cientificamente as ações apresentadas no processo de auditoria de enfermagem nas unidades de centro cirúrgico, a fim de alinhar o gerenciamento de enfermagem às atividades desempenhadas pela equipe cirúrgica. Trata-se de uma revisão integrativa da literatura, com a seguinte

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Section: Resultsunclassified

Section: Discussionunclassified

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Ações de auditoria de enfermagem em centro cirúrgico: revisão integrativa da literatura / Nursing audictory actions in surgery room: an integrative review of literature

Neves¹,

Oliveira²,

Aroni³

et al. 2021

BJDV

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“…Most recent and largest multi-centre analysis involving 84,320 cases of AIS surgeries in the SRS database reported an overall SSI rate of 0.52% [ 1 ]. Tipper et al [ 42 ] proved that adoption of a standardized protocol resulted in significant reduction of SSI risk in pediatric scoliosis surgery.…”

Section: Discussionmentioning

confidence: 99%

Perioperative outcome and complications following single-staged Posterior Spinal Fusion (PSF) using pedicle screw instrumentation in Adolescent Idiopathic Scoliosis (AIS): a review of 1057 cases from a single centre

Kwan

Loh

Chung

et al. 2021

BMC Musculoskelet Disord

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Background There has been a growing interest in using all pedicle screw construct in posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) surgery in recent years. However, studies focusing on perioperative outcome and complications utilizing only pedicle screw system in AIS population are lacking. This study aims to evaluate perioperative outcomes and to determine the prevalence of major and minor complications following single-staged PSF for AIS. Methods In this retrospective study of prospectively collected data, 1057 AIS patients operated between 2012 and 2019 were included. Main outcome measures were operative time, intraoperative blood loss, allogeneic blood transfusion rate, length of hospital stay after surgery, complication rate, and mean drop of haemoglobin (Hb) level. We documented the number of fusion levels, screw density, and postoperative radiographic parameters. Results There were 917 females and 140 males. Majority were Lenke 1 curve type (46.9%). Mean age was 15.6 ± 3.7 years, with mean BMI of 18.6 ± 3.2 kg/m2. Mean operative time was 146.8 ± 49.4 min. Average intraoperative blood loss was 952.9 ± 530.4 ml with allogeneic blood transfusion rate of 5%. Mean screw density was 1.27 ± 0.21 screws per fusion level. Average hospital stay after surgery was 3.5 ± 0.9 days. Twenty-four complications were documented: twelve superficial infections (1.14%), five transient neurological deficits (0.47%), two deep infections (0.19%), two superior mesenteric artery syndrome, and one case each (0.09%) for massive intraoperative blood loss, intraoperative seizure, and lung atelectasis. Conclusion AIS patients treated with single-staged PSF using pedicle screw construct had a 0.95% rate of major complications and 1.32% rate of minor complications. Rate of neurologic complication was 0.47% while non-neurologic postoperative complications was 1.80% with infection being the leading complication at 1.32%.

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Incidence of infection rate for shunt implantation: the zero % rate is always a myth

Diallo,

Beuriat,

Szathmari

et al. 2024

Childs Nerv Syst

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Introduction Paediatric CSF shunt infection rate remains a well-known complication that is not only responsible of potentially severe sequels for patients but also for economical expenses. In that study, we questioned if it is possible to attain the zero percent rate of infection that should be the goal of every paediatric neurosurgeon. Methods We report our series of patients treated with a CSF device from January the first 2016 to December 31 2018. Results In all 147 patients treated for hydrocephalus, the follow-up was of at least of 2 years from the implantation. Antibiotic-coated tubes were always used with a differential pressure valve system. A total of 172 surgical procedures were performed for 147 patients. In the follow-up time period, 4 patients presented a post-operative infection (2.3%). Two infections appeared early after the surgical procedure one after 24 h and the other after 6 days; the other two infections were diagnosed after 53 days and the other after 66 days. The germs responsible of the infections were a Staphylococcus capitals, an Escherichia coli, a Klebsiella pneumonia, and a Staphylococcus aureus. Conclusions Shunts will always be implanted especially in new-borns and for particular aetiologies of hydrocephalus. To reduce the rate of infection, the best thing to do is to adopt adapted protocols. Our low incidence of infection rate for shunts represent a long history to research preventive factors that helped us to improve our results during the time.

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Reducing Surgical Site Infection in Pediatric Scoliosis Surgery: A Multidisciplinary Improvement Program and Prospective 4-Year Audit

Cited by 17 publications

References 31 publications

Ações de auditoria de enfermagem em centro cirúrgico: revisão integrativa da literatura / Nursing audictory actions in surgery room: an integrative review of literature

Ações de auditoria de enfermagem em centro cirúrgico: revisão integrativa da literatura / Nursing audictory actions in surgery room: an integrative review of literature

Perioperative outcome and complications following single-staged Posterior Spinal Fusion (PSF) using pedicle screw instrumentation in Adolescent Idiopathic Scoliosis (AIS): a review of 1057 cases from a single centre

Incidence of infection rate for shunt implantation: the zero % rate is always a myth

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