Intervention to reduce the incidence of surgical site infection in spine surgery
•Surgical site infections (SSIs) in spinal surgery were mainly caused by enteric flora.•Body mass index and days until ambulation were associated with SSIs in multivariate analyses.•A multimodal intervention decreased by 78.1% the incidence of SSIs in spinal surgery.•The intervention included modifi...
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| Veröffentlicht in: | American journal of infection control 2020-05, Vol.48 (5), p.550-554 |
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| creator | Castellà, Laia Sopena, Nieves Rodriguez-Montserrat, David Alonso-Fernández, Sergio Cavanilles, Jose María Iborra, Miquel Ciercoles, Ana Pulido, Ana Gimenez, Montserrat Hernandez Hermoso, Jose Antonio Casas, Irma |
| description | •Surgical site infections (SSIs) in spinal surgery were mainly caused by enteric flora.•Body mass index and days until ambulation were associated with SSIs in multivariate analyses.•A multimodal intervention decreased by 78.1% the incidence of SSIs in spinal surgery.•The intervention included modification of wound dressing and early mobilization.
This study examines the incidence, characteristics, and risk factors of surgical site infections (SSIs) after spine surgery and evaluates the efficacy of a preventive intervention.
This was a quasi-experimental pretest/posttest study in patients undergoing spinal surgery in an orthopedic surgery department from December 2014 to November 2016. Based on the results of the study, we revised the preventive protocol with modification of wound dressing, staff training, and feedback. SSI rates were compared between the pre-intervention (December 2014 to November 2015) and post-intervention (December 2015 to November 2016) periods. The risk factors were analyzed using univariate and multivariate analyses.
Of the 139 patients included, 14 cases of SSI were diagnosed, with a significant decrease in the incidence of SSIs from the pre-intervention period to the post-intervention period (19.4% vs 2.6%; P = .001). The etiology was known in 13 cases, with enteric flora being predominant in the pre-intervention group. Univariate analysis showed that age, body mass index, days until sitting and ambulation, and incontinence were statistically significant risk factors. After multivariate analysis, only body mass index and days until ambulation remained significant. When the effect of intervention was adjusted with other risk factors, this variable remained statistically significant.
An intervention that includes modification of wound dressing and early mobilization, as well as staff awareness training, monitoring, and feedback, allowed a significant reduction in the incidence of SSI following spinal surgery, particularly infections caused by enteric flora. |
| doi_str_mv | 10.1016/j.ajic.2019.09.007 |
| format | Article |
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This study examines the incidence, characteristics, and risk factors of surgical site infections (SSIs) after spine surgery and evaluates the efficacy of a preventive intervention.
This was a quasi-experimental pretest/posttest study in patients undergoing spinal surgery in an orthopedic surgery department from December 2014 to November 2016. Based on the results of the study, we revised the preventive protocol with modification of wound dressing, staff training, and feedback. SSI rates were compared between the pre-intervention (December 2014 to November 2015) and post-intervention (December 2015 to November 2016) periods. The risk factors were analyzed using univariate and multivariate analyses.
Of the 139 patients included, 14 cases of SSI were diagnosed, with a significant decrease in the incidence of SSIs from the pre-intervention period to the post-intervention period (19.4% vs 2.6%; P = .001). The etiology was known in 13 cases, with enteric flora being predominant in the pre-intervention group. Univariate analysis showed that age, body mass index, days until sitting and ambulation, and incontinence were statistically significant risk factors. After multivariate analysis, only body mass index and days until ambulation remained significant. When the effect of intervention was adjusted with other risk factors, this variable remained statistically significant.
An intervention that includes modification of wound dressing and early mobilization, as well as staff awareness training, monitoring, and feedback, allowed a significant reduction in the incidence of SSI following spinal surgery, particularly infections caused by enteric flora.</description><identifier>ISSN: 0196-6553</identifier><identifier>EISSN: 1527-3296</identifier><identifier>DOI: 10.1016/j.ajic.2019.09.007</identifier><identifier>PMID: 31706545</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Bandages - microbiology ; Bandages - statistics & numerical data ; Body Mass Index ; Early Ambulation - statistics & numerical data ; Female ; Gastrointestinal Microbiome ; Humans ; Incidence ; Infection control ; Infection Control - methods ; Intervention ; Lumbar Vertebrae - surgery ; Male ; Middle Aged ; Multivariate Analysis ; Perioperative Care - methods ; Surgical site infection ; Surgical Wound Infection - epidemiology ; Surgical Wound Infection - microbiology ; Surgical Wound Infection - prevention & control ; Treatment Outcome</subject><ispartof>American journal of infection control, 2020-05, Vol.48 (5), p.550-554</ispartof><rights>2019 Association for Professionals in Infection Control and Epidemiology, Inc.</rights><rights>Copyright © 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-39a5e32f91e3f762319b9ffa0635751a3c37ed8aadf494c4220ea59887fd021a3</citedby><cites>FETCH-LOGICAL-c400t-39a5e32f91e3f762319b9ffa0635751a3c37ed8aadf494c4220ea59887fd021a3</cites><orcidid>0000-0001-6969-9380 ; 0000-0001-8841-810X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0196655319308223$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31706545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Castellà, Laia</creatorcontrib><creatorcontrib>Sopena, Nieves</creatorcontrib><creatorcontrib>Rodriguez-Montserrat, David</creatorcontrib><creatorcontrib>Alonso-Fernández, Sergio</creatorcontrib><creatorcontrib>Cavanilles, Jose María</creatorcontrib><creatorcontrib>Iborra, Miquel</creatorcontrib><creatorcontrib>Ciercoles, Ana</creatorcontrib><creatorcontrib>Pulido, Ana</creatorcontrib><creatorcontrib>Gimenez, Montserrat</creatorcontrib><creatorcontrib>Hernandez Hermoso, Jose Antonio</creatorcontrib><creatorcontrib>Casas, Irma</creatorcontrib><title>Intervention to reduce the incidence of surgical site infection in spine surgery</title><title>American journal of infection control</title><addtitle>Am J Infect Control</addtitle><description>•Surgical site infections (SSIs) in spinal surgery were mainly caused by enteric flora.•Body mass index and days until ambulation were associated with SSIs in multivariate analyses.•A multimodal intervention decreased by 78.1% the incidence of SSIs in spinal surgery.•The intervention included modification of wound dressing and early mobilization.
This study examines the incidence, characteristics, and risk factors of surgical site infections (SSIs) after spine surgery and evaluates the efficacy of a preventive intervention.
This was a quasi-experimental pretest/posttest study in patients undergoing spinal surgery in an orthopedic surgery department from December 2014 to November 2016. Based on the results of the study, we revised the preventive protocol with modification of wound dressing, staff training, and feedback. SSI rates were compared between the pre-intervention (December 2014 to November 2015) and post-intervention (December 2015 to November 2016) periods. The risk factors were analyzed using univariate and multivariate analyses.
Of the 139 patients included, 14 cases of SSI were diagnosed, with a significant decrease in the incidence of SSIs from the pre-intervention period to the post-intervention period (19.4% vs 2.6%; P = .001). The etiology was known in 13 cases, with enteric flora being predominant in the pre-intervention group. Univariate analysis showed that age, body mass index, days until sitting and ambulation, and incontinence were statistically significant risk factors. After multivariate analysis, only body mass index and days until ambulation remained significant. When the effect of intervention was adjusted with other risk factors, this variable remained statistically significant.
An intervention that includes modification of wound dressing and early mobilization, as well as staff awareness training, monitoring, and feedback, allowed a significant reduction in the incidence of SSI following spinal surgery, particularly infections caused by enteric flora.</description><subject>Adult</subject><subject>Aged</subject><subject>Bandages - microbiology</subject><subject>Bandages - statistics & numerical data</subject><subject>Body Mass Index</subject><subject>Early Ambulation - statistics & numerical data</subject><subject>Female</subject><subject>Gastrointestinal Microbiome</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infection control</subject><subject>Infection Control - methods</subject><subject>Intervention</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Perioperative Care - methods</subject><subject>Surgical site infection</subject><subject>Surgical Wound Infection - epidemiology</subject><subject>Surgical Wound Infection - microbiology</subject><subject>Surgical Wound Infection - prevention & control</subject><subject>Treatment Outcome</subject><issn>0196-6553</issn><issn>1527-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMotlb_gAfZo5etk2STbcCLFD8KBT3oOaTZiaa0uzXZLfTfm22rR2FgGN4PmIeQawpjClTeLcdm6e2YAVVjSAPlCRlSwcqcMyVPyTAJMpdC8AG5iHEJAIpLcU4GnJYgRSGG5G1Wtxi2WLe-qbO2yQJWncWs_cLM19ZXWKercVnswqe3ZpVF3_aSQ7uP-DqLG1_j3oBhd0nOnFlFvDruEfl4enyfvuTz1-fZ9GGe2wKgzbkyAjlziiJ3pWScqoVyzoDkohTUcMtLrCbGVK5QhS0YAzRCTSalq4AlfURuD72b0Hx3GFu99tHiamVqbLqoUyOXhaCySFZ2sNrQxBjQ6U3waxN2moLuSeql7knqnqSGNFCm0M2xv1ussfqL_KJLhvuDAdOXW49BR-t7WpUPiY2uGv9f_w-zrISu</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Castellà, Laia</creator><creator>Sopena, Nieves</creator><creator>Rodriguez-Montserrat, David</creator><creator>Alonso-Fernández, Sergio</creator><creator>Cavanilles, Jose María</creator><creator>Iborra, Miquel</creator><creator>Ciercoles, Ana</creator><creator>Pulido, Ana</creator><creator>Gimenez, Montserrat</creator><creator>Hernandez Hermoso, Jose Antonio</creator><creator>Casas, Irma</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6969-9380</orcidid><orcidid>https://orcid.org/0000-0001-8841-810X</orcidid></search><sort><creationdate>202005</creationdate><title>Intervention to reduce the incidence of surgical site infection in spine surgery</title><author>Castellà, Laia ; Sopena, Nieves ; Rodriguez-Montserrat, David ; Alonso-Fernández, Sergio ; Cavanilles, Jose María ; Iborra, Miquel ; Ciercoles, Ana ; Pulido, Ana ; Gimenez, Montserrat ; Hernandez Hermoso, Jose Antonio ; Casas, Irma</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-39a5e32f91e3f762319b9ffa0635751a3c37ed8aadf494c4220ea59887fd021a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Bandages - microbiology</topic><topic>Bandages - statistics & numerical data</topic><topic>Body Mass Index</topic><topic>Early Ambulation - statistics & numerical data</topic><topic>Female</topic><topic>Gastrointestinal Microbiome</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infection control</topic><topic>Infection Control - methods</topic><topic>Intervention</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Perioperative Care - methods</topic><topic>Surgical site infection</topic><topic>Surgical Wound Infection - epidemiology</topic><topic>Surgical Wound Infection - microbiology</topic><topic>Surgical Wound Infection - prevention & control</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Castellà, Laia</creatorcontrib><creatorcontrib>Sopena, Nieves</creatorcontrib><creatorcontrib>Rodriguez-Montserrat, David</creatorcontrib><creatorcontrib>Alonso-Fernández, Sergio</creatorcontrib><creatorcontrib>Cavanilles, Jose María</creatorcontrib><creatorcontrib>Iborra, Miquel</creatorcontrib><creatorcontrib>Ciercoles, Ana</creatorcontrib><creatorcontrib>Pulido, Ana</creatorcontrib><creatorcontrib>Gimenez, Montserrat</creatorcontrib><creatorcontrib>Hernandez Hermoso, Jose Antonio</creatorcontrib><creatorcontrib>Casas, Irma</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of infection control</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Castellà, Laia</au><au>Sopena, Nieves</au><au>Rodriguez-Montserrat, David</au><au>Alonso-Fernández, Sergio</au><au>Cavanilles, Jose María</au><au>Iborra, Miquel</au><au>Ciercoles, Ana</au><au>Pulido, Ana</au><au>Gimenez, Montserrat</au><au>Hernandez Hermoso, Jose Antonio</au><au>Casas, Irma</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intervention to reduce the incidence of surgical site infection in spine surgery</atitle><jtitle>American journal of infection control</jtitle><addtitle>Am J Infect Control</addtitle><date>2020-05</date><risdate>2020</risdate><volume>48</volume><issue>5</issue><spage>550</spage><epage>554</epage><pages>550-554</pages><issn>0196-6553</issn><eissn>1527-3296</eissn><abstract>•Surgical site infections (SSIs) in spinal surgery were mainly caused by enteric flora.•Body mass index and days until ambulation were associated with SSIs in multivariate analyses.•A multimodal intervention decreased by 78.1% the incidence of SSIs in spinal surgery.•The intervention included modification of wound dressing and early mobilization.
This study examines the incidence, characteristics, and risk factors of surgical site infections (SSIs) after spine surgery and evaluates the efficacy of a preventive intervention.
This was a quasi-experimental pretest/posttest study in patients undergoing spinal surgery in an orthopedic surgery department from December 2014 to November 2016. Based on the results of the study, we revised the preventive protocol with modification of wound dressing, staff training, and feedback. SSI rates were compared between the pre-intervention (December 2014 to November 2015) and post-intervention (December 2015 to November 2016) periods. The risk factors were analyzed using univariate and multivariate analyses.
Of the 139 patients included, 14 cases of SSI were diagnosed, with a significant decrease in the incidence of SSIs from the pre-intervention period to the post-intervention period (19.4% vs 2.6%; P = .001). The etiology was known in 13 cases, with enteric flora being predominant in the pre-intervention group. Univariate analysis showed that age, body mass index, days until sitting and ambulation, and incontinence were statistically significant risk factors. After multivariate analysis, only body mass index and days until ambulation remained significant. When the effect of intervention was adjusted with other risk factors, this variable remained statistically significant.
An intervention that includes modification of wound dressing and early mobilization, as well as staff awareness training, monitoring, and feedback, allowed a significant reduction in the incidence of SSI following spinal surgery, particularly infections caused by enteric flora.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31706545</pmid><doi>10.1016/j.ajic.2019.09.007</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-6969-9380</orcidid><orcidid>https://orcid.org/0000-0001-8841-810X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Aged Bandages - microbiology Bandages - statistics & numerical data Body Mass Index Early Ambulation - statistics & numerical data Female Gastrointestinal Microbiome Humans Incidence Infection control Infection Control - methods Intervention Lumbar Vertebrae - surgery Male Middle Aged Multivariate Analysis Perioperative Care - methods Surgical site infection Surgical Wound Infection - epidemiology Surgical Wound Infection - microbiology Surgical Wound Infection - prevention & control Treatment Outcome |
| title | Intervention to reduce the incidence of surgical site infection in spine surgery |
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