• Leire Zarain-Obrador, Marcos Alonso-García, Pablo Gil-Yonte, Ana I Hijas-Gómez, Diego Rodríguez-Villar, Brezo Martínez-Amores, Ángel Gil-de-Miguel, Jaime Ruiz-Tovar, Gil Rodríguez-Caravaca, and Manuel Durán-Poveda.
• Department of Surgery, Rey Juan Carlos Hospital, Móstoles, Madrid, Spain.
• Rev Invest Clin. 2021 May 4; 73 (4): 251-258.

BackgroundSurgical site infections (SSI) have an important impact on morbidity and mortality.ObjectiveThis study, therefore, sought to assess the effect of a surgical care bundle on the incidence of SSI in colorectal surgery.MethodsWe conducted a quasi-experimental intervention study with reference to the introduction of a surgical care bundle in 2011. Our study population, made up of patients who underwent colorectal surgery, was divided into the following two periods: 2007-2011 (pre-intervention) and 2012-2017 (post-intervention). The intervention's effect on SSI incidence was analyzed using adjusted odds ratios (OR).ResultsA total of 1,727 patients were included in the study. SSI incidence was 13.0% before versus 11.6% after implementation of the care bundle (OR: 0.88, 95% confidence interval: 0.66-1.17, p = 0.37). Multivariate analysis showed that cancer, chronic obstructive pulmonary disease, neutropenia, and emergency surgery were independently associated with SSI. In contrast, laparoscopic surgery proved to be a protective factor against SSI.ConclusionsCare bundles have proven to be very important in reducing SSI incidence since the measures that constitute these protocols are mutually reinforcing. In our study, the implementation of a care bundle reduced SSI incidence from 13% to 11.6%, though the reduction was not statistically significant.

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