Impact of intraoperative behavior on surgical site infections
Abstract Background The aim of this study was to identify intraoperative risk factors for surgical site infections (SSIs), which are accessible to interventions. We evaluated the effect of extensive intraoperative antiseptic measures and the impact of the behavior of members of the surgical team on...
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| Veröffentlicht in: | The American journal of surgery 2009-08, Vol.198 (2), p.157-162 |
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| creator | Beldi, Guido, M.D Bisch-Knaden, Sonja, Ph.D Banz, Vanessa, M.D Mühlemann, Kathrin, M.D., Ph.D Candinas, Daniel, M.D |
| description | Abstract Background The aim of this study was to identify intraoperative risk factors for surgical site infections (SSIs), which are accessible to interventions. We evaluated the effect of extensive intraoperative antiseptic measures and the impact of the behavior of members of the surgical team on SSIs. Methods Standard versus extensive antiseptic measures were randomly assigned in 1,032 surgical patients. The adherence to principles of asepsis by members of the surgical team was assessed prospectively. Results The rate of SSI was 14% with standard antiseptic measures and 15% with extensive measures ( P = .581). Multivariate analysis identified following independent risk factors: lapses in discipline (odds ratio [OR] 2.02, confidence interval [CI] 1.05–3.88), intestinal anastomosis (OR 6.74, CI 3.42–13.30), duration of operation more than 3 hours (OR 3.34, CI 1.82–6.14), and body mass index >30 kg/m2 (OR 1.98, CI 1.22–3.20). Conclusion Extensive measures of antisepsis did not reduce the incidence of SSI. A lapse to adhere to principles of asepsis was identified as an independent risk factor for the development of SSI ( ClinicalTrials.gov number, NCT00555815 ). |
| doi_str_mv | 10.1016/j.amjsurg.2008.09.023 |
| format | Article |
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We evaluated the effect of extensive intraoperative antiseptic measures and the impact of the behavior of members of the surgical team on SSIs. Methods Standard versus extensive antiseptic measures were randomly assigned in 1,032 surgical patients. The adherence to principles of asepsis by members of the surgical team was assessed prospectively. Results The rate of SSI was 14% with standard antiseptic measures and 15% with extensive measures ( P = .581). Multivariate analysis identified following independent risk factors: lapses in discipline (odds ratio [OR] 2.02, confidence interval [CI] 1.05–3.88), intestinal anastomosis (OR 6.74, CI 3.42–13.30), duration of operation more than 3 hours (OR 3.34, CI 1.82–6.14), and body mass index >30 kg/m2 (OR 1.98, CI 1.22–3.20). Conclusion Extensive measures of antisepsis did not reduce the incidence of SSI. A lapse to adhere to principles of asepsis was identified as an independent risk factor for the development of SSI ( ClinicalTrials.gov number, NCT00555815 ).</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2008.09.023</identifier><identifier>PMID: 19285307</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject><![CDATA[Abdomen ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anastomosis ; Anastomosis, Surgical ; Anti-Infective Agents, Local - administration & dosage ; Antibiotics ; Asepsis ; Aseptic measures ; Behavior ; Biological and medical sciences ; Body mass ; Body Mass Index ; Child ; Child, Preschool ; Clinical trials ; Colorectal Surgery ; Confidence intervals ; Discipline ; Disinfection & disinfectants ; Equipment and Supplies, Hospital ; Equipment Contamination - prevention & control ; Female ; General aspects ; Hospitals ; Human infectious diseases. Experimental studies and models ; Humans ; Incidence ; Infection Control - methods ; Infectious diseases ; Intestine ; Intestines - surgery ; Intraoperative Care ; Iodine ; Isotonic Solutions ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Nosocomial infections ; Operating Rooms ; Patient Care Team ; Patients ; Povidone-Iodine - administration & dosage ; Prospective Studies ; Protective Devices ; Risk analysis ; Risk Factors ; Skin ; Sterilization ; Surgeons ; Surgery ; Surgical apparatus & instruments ; Surgical site infection ; Surgical site infections ; Surgical team members ; Surgical Wound Infection - prevention & control ; Temperature ; Time Factors]]></subject><ispartof>The American journal of surgery, 2009-08, Vol.198 (2), p.157-162</ispartof><rights>Elsevier Inc.</rights><rights>2009 Elsevier Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Limited Aug 1, 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c542t-291bddeb352c98d07efa342aac8f1e4f3f8abc2f4b980e4db59baa71183c98e33</citedby><cites>FETCH-LOGICAL-c542t-291bddeb352c98d07efa342aac8f1e4f3f8abc2f4b980e4db59baa71183c98e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1924850593?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,3550,23930,23931,25140,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21780773$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19285307$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Beldi, Guido, M.D</creatorcontrib><creatorcontrib>Bisch-Knaden, Sonja, Ph.D</creatorcontrib><creatorcontrib>Banz, Vanessa, M.D</creatorcontrib><creatorcontrib>Mühlemann, Kathrin, M.D., Ph.D</creatorcontrib><creatorcontrib>Candinas, Daniel, M.D</creatorcontrib><title>Impact of intraoperative behavior on surgical site infections</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background The aim of this study was to identify intraoperative risk factors for surgical site infections (SSIs), which are accessible to interventions. We evaluated the effect of extensive intraoperative antiseptic measures and the impact of the behavior of members of the surgical team on SSIs. Methods Standard versus extensive antiseptic measures were randomly assigned in 1,032 surgical patients. The adherence to principles of asepsis by members of the surgical team was assessed prospectively. Results The rate of SSI was 14% with standard antiseptic measures and 15% with extensive measures ( P = .581). Multivariate analysis identified following independent risk factors: lapses in discipline (odds ratio [OR] 2.02, confidence interval [CI] 1.05–3.88), intestinal anastomosis (OR 6.74, CI 3.42–13.30), duration of operation more than 3 hours (OR 3.34, CI 1.82–6.14), and body mass index >30 kg/m2 (OR 1.98, CI 1.22–3.20). Conclusion Extensive measures of antisepsis did not reduce the incidence of SSI. A lapse to adhere to principles of asepsis was identified as an independent risk factor for the development of SSI ( ClinicalTrials.gov number, NCT00555815 ).</description><subject>Abdomen</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anastomosis</subject><subject>Anastomosis, Surgical</subject><subject>Anti-Infective Agents, Local - administration & dosage</subject><subject>Antibiotics</subject><subject>Asepsis</subject><subject>Aseptic measures</subject><subject>Behavior</subject><subject>Biological and medical sciences</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical trials</subject><subject>Colorectal Surgery</subject><subject>Confidence intervals</subject><subject>Discipline</subject><subject>Disinfection & disinfectants</subject><subject>Equipment and Supplies, Hospital</subject><subject>Equipment Contamination - prevention & control</subject><subject>Female</subject><subject>General aspects</subject><subject>Hospitals</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infection Control - methods</subject><subject>Infectious diseases</subject><subject>Intestine</subject><subject>Intestines - surgery</subject><subject>Intraoperative Care</subject><subject>Iodine</subject><subject>Isotonic Solutions</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Nosocomial infections</subject><subject>Operating Rooms</subject><subject>Patient Care Team</subject><subject>Patients</subject><subject>Povidone-Iodine - administration & dosage</subject><subject>Prospective Studies</subject><subject>Protective Devices</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Skin</subject><subject>Sterilization</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical apparatus & instruments</subject><subject>Surgical site infection</subject><subject>Surgical site infections</subject><subject>Surgical team members</subject><subject>Surgical Wound Infection - prevention & control</subject><subject>Temperature</subject><subject>Time Factors</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkktr3TAQRkVIaW7T_oQEQ2h3dkeSH9KiLSX0EQh00XYtZHmUyLGtW8m-kH9fmWsayKYgEIIzn2aORMgFhYICrd_3hR77uIS7ggGIAmQBjJ-QHRWNzKkQ_JTsAIDlsqZwRl7F2KcjpSV_Sc6oZKLi0OzIh5txr82ceZu5aQ7a7zHo2R0wa_FeH5wPmZ-y9R5n9JBFN2MCLZrZ-Sm-Ji-sHiK-2fZz8vvrl1_X3_PbH99urj_f5qYq2ZwzSduuw5ZXzEjRQYNW85JpbYSlWFpuhW4Ns2UrBWDZtZVstW4oFTzxyPk5eXfM3Qf_Z8E4q9FFg8OgJ_RLVHVT0VLUIoFXz8DeL2FKvak0cykqqOQaVx0pE3yMAa3aBzfq8KgoqNWu6tVmV612FUiV7Ka6yy19aUfsnqo2nQl4uwE6Jl026Mm4-I9jtBHQNGvQpyOHSdrBYVDROJwMdi4ktarz7r-tfHyWYAY3rW_0gI8Yn6ZWkSlQP9evsP4EEGnJWvK_99mv5g</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>Beldi, Guido, M.D</creator><creator>Bisch-Knaden, Sonja, Ph.D</creator><creator>Banz, Vanessa, M.D</creator><creator>Mühlemann, Kathrin, M.D., Ph.D</creator><creator>Candinas, Daniel, M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><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>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20090801</creationdate><title>Impact of intraoperative behavior on surgical site infections</title><author>Beldi, Guido, M.D ; Bisch-Knaden, Sonja, Ph.D ; Banz, Vanessa, M.D ; Mühlemann, Kathrin, M.D., Ph.D ; Candinas, Daniel, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c542t-291bddeb352c98d07efa342aac8f1e4f3f8abc2f4b980e4db59baa71183c98e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abdomen</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anastomosis</topic><topic>Anastomosis, Surgical</topic><topic>Anti-Infective Agents, Local - administration & dosage</topic><topic>Antibiotics</topic><topic>Asepsis</topic><topic>Aseptic measures</topic><topic>Behavior</topic><topic>Biological and medical sciences</topic><topic>Body mass</topic><topic>Body Mass Index</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clinical trials</topic><topic>Colorectal Surgery</topic><topic>Confidence intervals</topic><topic>Discipline</topic><topic>Disinfection & disinfectants</topic><topic>Equipment and Supplies, Hospital</topic><topic>Equipment Contamination - prevention & control</topic><topic>Female</topic><topic>General aspects</topic><topic>Hospitals</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infection Control - methods</topic><topic>Infectious diseases</topic><topic>Intestine</topic><topic>Intestines - surgery</topic><topic>Intraoperative Care</topic><topic>Iodine</topic><topic>Isotonic Solutions</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Nosocomial infections</topic><topic>Operating Rooms</topic><topic>Patient Care Team</topic><topic>Patients</topic><topic>Povidone-Iodine - administration & dosage</topic><topic>Prospective Studies</topic><topic>Protective Devices</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Skin</topic><topic>Sterilization</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical apparatus & instruments</topic><topic>Surgical site infection</topic><topic>Surgical site infections</topic><topic>Surgical team members</topic><topic>Surgical Wound Infection - prevention & control</topic><topic>Temperature</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beldi, Guido, M.D</creatorcontrib><creatorcontrib>Bisch-Knaden, Sonja, Ph.D</creatorcontrib><creatorcontrib>Banz, Vanessa, M.D</creatorcontrib><creatorcontrib>Mühlemann, Kathrin, M.D., Ph.D</creatorcontrib><creatorcontrib>Candinas, Daniel, M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beldi, Guido, M.D</au><au>Bisch-Knaden, Sonja, Ph.D</au><au>Banz, Vanessa, M.D</au><au>Mühlemann, Kathrin, M.D., Ph.D</au><au>Candinas, Daniel, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of intraoperative behavior on surgical site infections</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>198</volume><issue>2</issue><spage>157</spage><epage>162</epage><pages>157-162</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Abstract Background The aim of this study was to identify intraoperative risk factors for surgical site infections (SSIs), which are accessible to interventions. We evaluated the effect of extensive intraoperative antiseptic measures and the impact of the behavior of members of the surgical team on SSIs. Methods Standard versus extensive antiseptic measures were randomly assigned in 1,032 surgical patients. The adherence to principles of asepsis by members of the surgical team was assessed prospectively. Results The rate of SSI was 14% with standard antiseptic measures and 15% with extensive measures ( P = .581). Multivariate analysis identified following independent risk factors: lapses in discipline (odds ratio [OR] 2.02, confidence interval [CI] 1.05–3.88), intestinal anastomosis (OR 6.74, CI 3.42–13.30), duration of operation more than 3 hours (OR 3.34, CI 1.82–6.14), and body mass index >30 kg/m2 (OR 1.98, CI 1.22–3.20). Conclusion Extensive measures of antisepsis did not reduce the incidence of SSI. A lapse to adhere to principles of asepsis was identified as an independent risk factor for the development of SSI ( ClinicalTrials.gov number, NCT00555815 ).</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19285307</pmid><doi>10.1016/j.amjsurg.2008.09.023</doi><tpages>6</tpages></addata></record> |
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| subjects | Abdomen Adolescent Adult Aged Aged, 80 and over Anastomosis Anastomosis, Surgical Anti-Infective Agents, Local - administration & dosage Antibiotics Asepsis Aseptic measures Behavior Biological and medical sciences Body mass Body Mass Index Child Child, Preschool Clinical trials Colorectal Surgery Confidence intervals Discipline Disinfection & disinfectants Equipment and Supplies, Hospital Equipment Contamination - prevention & control Female General aspects Hospitals Human infectious diseases. Experimental studies and models Humans Incidence Infection Control - methods Infectious diseases Intestine Intestines - surgery Intraoperative Care Iodine Isotonic Solutions Male Medical sciences Middle Aged Multivariate Analysis Nosocomial infections Operating Rooms Patient Care Team Patients Povidone-Iodine - administration & dosage Prospective Studies Protective Devices Risk analysis Risk Factors Skin Sterilization Surgeons Surgery Surgical apparatus & instruments Surgical site infection Surgical site infections Surgical team members Surgical Wound Infection - prevention & control Temperature Time Factors |
| title | Impact of intraoperative behavior on surgical site infections |
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