Impact of a Surgical Wound Infection Prevention Bundle in Pediatric Cardiothoracic Surgery
The aim of this project was to decrease the incidence of surgical wound infection (SWI) to
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| Veröffentlicht in: | The Annals of thoracic surgery 2023-01, Vol.115 (1), p.126-134 |
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| container_title | The Annals of thoracic surgery |
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| creator | Glenn, Emilee T. Harman, Jeremy R. Marietta, Jennifer Lake, Jason Bailly, David K. Ou, Zhining Griffiths, Eric R. Ware, Adam L. |
| description | The aim of this project was to decrease the incidence of surgical wound infection (SWI) to |
| doi_str_mv | 10.1016/j.athoracsur.2022.08.045 |
| format | Article |
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An SWI prevention bundle addressing preoperative, intraoperative, and postoperative risks was implemented. The primary outcome was SWI based on Society of Thoracic Surgeons criteria (superficial, deep, or mediastinitis). Novel aspects of the bundle included standardization of surgical closure and wound coverage for 14 days with a negative pressure dressing or a silicone dressing. Data were collected from January 2017 to November 2021; bundle intervention began in December 2019. SWIs were tracked using a g-chart. Preintervention and postintervention cohorts were compared by standard descriptive statistics. There were no changes in SWI tracking methods during the study.
During the study, 1159 individuals underwent 1768 surgical interventions. Preintervention (n = 931) and postintervention (n = 837) groups were clinically similar, with fewer neonatal surgeries in the postintervention group. SWI decreased in all patients (preintervention period: 1 SWI per 22 surgeries; postintervention period: 1 SWI per 62.6 surgeries) and in neonates (preintervention period: 1 SWI per 12 surgeries; postintervention period: 1 SWI per 26.7 surgeries). Special cause variation was achieved in the entire cohort by March 2021 and in neonates by April 2021. Decreases in SWI occurred in superficial and deep wounds but not in mediastinitis. Annual rate of total SWIs decreased from 2.83% in 2019 to 1.15% in 2021. Intensive care unit and hospital length of stay did not change.
We demonstrated a reduction in SWI rates after implementing an SWI prevention bundle including standardized surgical closure and prolonged wound protection.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/j.athoracsur.2022.08.045</identifier><identifier>PMID: 36126719</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Cardiac Surgical Procedures - adverse effects ; Child ; Humans ; Infant, Newborn ; Mediastinitis - epidemiology ; Sternotomy - adverse effects ; Surgical Wound Infection - epidemiology ; Surgical Wound Infection - etiology ; Surgical Wound Infection - prevention & control</subject><ispartof>The Annals of thoracic surgery, 2023-01, Vol.115 (1), p.126-134</ispartof><rights>2023 The Society of Thoracic Surgeons</rights><rights>Copyright © 2023 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c374t-126108a22fec79e72a27ad96bc95498214d8737d0000ee9adb009485a2788e7c3</citedby><cites>FETCH-LOGICAL-c374t-126108a22fec79e72a27ad96bc95498214d8737d0000ee9adb009485a2788e7c3</cites><orcidid>0000-0002-4515-6557</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.athoracsur.2022.08.045$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36126719$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Glenn, Emilee T.</creatorcontrib><creatorcontrib>Harman, Jeremy R.</creatorcontrib><creatorcontrib>Marietta, Jennifer</creatorcontrib><creatorcontrib>Lake, Jason</creatorcontrib><creatorcontrib>Bailly, David K.</creatorcontrib><creatorcontrib>Ou, Zhining</creatorcontrib><creatorcontrib>Griffiths, Eric R.</creatorcontrib><creatorcontrib>Ware, Adam L.</creatorcontrib><title>Impact of a Surgical Wound Infection Prevention Bundle in Pediatric Cardiothoracic Surgery</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>The aim of this project was to decrease the incidence of surgical wound infection (SWI) to <1.5% in our pediatric cardiothoracic surgery patients using a prevention bundle and quality improvement process.
An SWI prevention bundle addressing preoperative, intraoperative, and postoperative risks was implemented. The primary outcome was SWI based on Society of Thoracic Surgeons criteria (superficial, deep, or mediastinitis). Novel aspects of the bundle included standardization of surgical closure and wound coverage for 14 days with a negative pressure dressing or a silicone dressing. Data were collected from January 2017 to November 2021; bundle intervention began in December 2019. SWIs were tracked using a g-chart. Preintervention and postintervention cohorts were compared by standard descriptive statistics. There were no changes in SWI tracking methods during the study.
During the study, 1159 individuals underwent 1768 surgical interventions. Preintervention (n = 931) and postintervention (n = 837) groups were clinically similar, with fewer neonatal surgeries in the postintervention group. SWI decreased in all patients (preintervention period: 1 SWI per 22 surgeries; postintervention period: 1 SWI per 62.6 surgeries) and in neonates (preintervention period: 1 SWI per 12 surgeries; postintervention period: 1 SWI per 26.7 surgeries). Special cause variation was achieved in the entire cohort by March 2021 and in neonates by April 2021. Decreases in SWI occurred in superficial and deep wounds but not in mediastinitis. Annual rate of total SWIs decreased from 2.83% in 2019 to 1.15% in 2021. Intensive care unit and hospital length of stay did not change.
We demonstrated a reduction in SWI rates after implementing an SWI prevention bundle including standardized surgical closure and prolonged wound protection.</description><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Child</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Mediastinitis - epidemiology</subject><subject>Sternotomy - adverse effects</subject><subject>Surgical Wound Infection - epidemiology</subject><subject>Surgical Wound Infection - etiology</subject><subject>Surgical Wound Infection - prevention & control</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtPAyEUhYnR2Pr4C4almxmBGQZYauOjiYkmakzcEAq3SjMdKsyY-O-lturSFVzuufccPoQwJSUltDlblKZ_C9HYNMSSEcZKIktS8x00ppyzomFc7aIxIaQqaiX4CB2ktMgly-19NKoayhpB1Ri9TJcrY3sc5tjghyG-emta_ByGzuFpNwfb-9Dh-wgf0H1fL3KnBezzIzhv-ugtnpjofNgkyuV6DcTPI7Q3N22C4-15iJ6uLh8nN8Xt3fV0cn5b2ErUfZGTUCINY9lMKBDMMGGcamZW8VpJRmsnRSVcTk8AlHEzQlQteZZJCcJWh-h0s3cVw_sAqddLnyy0rekgDEkzQRvOOCE8S-VGamNIKcJcr6JfmvipKdFrsnqh_8jqNVlNpM5k8-jJ1mWYLcH9Dv6gzIKLjQDyXz88RJ2sh85mSjFj1C74_12-ACbrjyg</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Glenn, Emilee T.</creator><creator>Harman, Jeremy R.</creator><creator>Marietta, Jennifer</creator><creator>Lake, Jason</creator><creator>Bailly, David K.</creator><creator>Ou, Zhining</creator><creator>Griffiths, Eric R.</creator><creator>Ware, Adam L.</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/0000-0002-4515-6557</orcidid></search><sort><creationdate>202301</creationdate><title>Impact of a Surgical Wound Infection Prevention Bundle in Pediatric Cardiothoracic Surgery</title><author>Glenn, Emilee T. ; Harman, Jeremy R. ; Marietta, Jennifer ; Lake, Jason ; Bailly, David K. ; Ou, Zhining ; Griffiths, Eric R. ; Ware, Adam L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c374t-126108a22fec79e72a27ad96bc95498214d8737d0000ee9adb009485a2788e7c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Child</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Mediastinitis - epidemiology</topic><topic>Sternotomy - adverse effects</topic><topic>Surgical Wound Infection - epidemiology</topic><topic>Surgical Wound Infection - etiology</topic><topic>Surgical Wound Infection - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Glenn, Emilee T.</creatorcontrib><creatorcontrib>Harman, Jeremy R.</creatorcontrib><creatorcontrib>Marietta, Jennifer</creatorcontrib><creatorcontrib>Lake, Jason</creatorcontrib><creatorcontrib>Bailly, David K.</creatorcontrib><creatorcontrib>Ou, Zhining</creatorcontrib><creatorcontrib>Griffiths, Eric R.</creatorcontrib><creatorcontrib>Ware, Adam L.</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>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Glenn, Emilee T.</au><au>Harman, Jeremy R.</au><au>Marietta, Jennifer</au><au>Lake, Jason</au><au>Bailly, David K.</au><au>Ou, Zhining</au><au>Griffiths, Eric R.</au><au>Ware, Adam L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of a Surgical Wound Infection Prevention Bundle in Pediatric Cardiothoracic Surgery</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2023-01</date><risdate>2023</risdate><volume>115</volume><issue>1</issue><spage>126</spage><epage>134</epage><pages>126-134</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>The aim of this project was to decrease the incidence of surgical wound infection (SWI) to <1.5% in our pediatric cardiothoracic surgery patients using a prevention bundle and quality improvement process.
An SWI prevention bundle addressing preoperative, intraoperative, and postoperative risks was implemented. The primary outcome was SWI based on Society of Thoracic Surgeons criteria (superficial, deep, or mediastinitis). Novel aspects of the bundle included standardization of surgical closure and wound coverage for 14 days with a negative pressure dressing or a silicone dressing. Data were collected from January 2017 to November 2021; bundle intervention began in December 2019. SWIs were tracked using a g-chart. Preintervention and postintervention cohorts were compared by standard descriptive statistics. There were no changes in SWI tracking methods during the study.
During the study, 1159 individuals underwent 1768 surgical interventions. Preintervention (n = 931) and postintervention (n = 837) groups were clinically similar, with fewer neonatal surgeries in the postintervention group. SWI decreased in all patients (preintervention period: 1 SWI per 22 surgeries; postintervention period: 1 SWI per 62.6 surgeries) and in neonates (preintervention period: 1 SWI per 12 surgeries; postintervention period: 1 SWI per 26.7 surgeries). Special cause variation was achieved in the entire cohort by March 2021 and in neonates by April 2021. Decreases in SWI occurred in superficial and deep wounds but not in mediastinitis. Annual rate of total SWIs decreased from 2.83% in 2019 to 1.15% in 2021. Intensive care unit and hospital length of stay did not change.
We demonstrated a reduction in SWI rates after implementing an SWI prevention bundle including standardized surgical closure and prolonged wound protection.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>36126719</pmid><doi>10.1016/j.athoracsur.2022.08.045</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4515-6557</orcidid></addata></record> |
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| subjects | Cardiac Surgical Procedures - adverse effects Child Humans Infant, Newborn Mediastinitis - epidemiology Sternotomy - adverse effects Surgical Wound Infection - epidemiology Surgical Wound Infection - etiology Surgical Wound Infection - prevention & control |
| title | Impact of a Surgical Wound Infection Prevention Bundle in Pediatric Cardiothoracic Surgery |
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