• Ann Vasc Surg · May 2017

    Observational Study

    Evaluation of the Bundle "Zero Surgical Site Infection" to Prevent Surgical Site Infection in Vascular Surgery.

    • María Fernández-Prada, Carmen Martínez-Ortega, Livia Revuelta-Mariño, Ángeles Menéndez-Herrero, and Juan F Navarro-Gracia.
    • Preventive Medicine and Public Health Service, University Hospital Central of Asturias, Oviedo, Asturias, Spain; Preventive Medicine and Public and Communitary Area, Medicine Department, Faculty of Medicine, Oviedo University, Oviedo, Asturias, Spain. Electronic address: mariafdezprada@gmail.com.
    • Ann Vasc Surg. 2017 May 1; 41: 160-168.

    BackgroundTo compare the incidence of surgical site infections (SSIs) before and after the implementation of a bundle of care called "Zero Surgical Site Infection." Secondary goals included estimating measures of association and their potential impact, determining care management indicators in vascular surgery, and evaluating the level of compliance with the bundle.MethodsThis is a prospective observational study with a historic control group. The bundle included (1) removal of body hair with clippers; (2) preoperative showering with chlorhexidine soap; (3) preparation of the surgical field with alcoholic chlorhexidine 2%; (4) adequacy of antimicrobial prophylaxis; (5) intraoperative and (6) postoperative glycemic and central temperature control. Student's t-test and chi-squared test were performed. Relative risk, attributable risk, number needed to treat, and preventable fraction were used as association and impact measures.ResultsIn total, 192 patients were included. The overall incidence of SSI was 8.85%; the preventive fraction was 59.1%. The rate of incidence of SSI for clean surgery was reduced from 4.9% to 0% (P = 0.127), whereas the average hospital stay decreased from 22.38 to 13.70 days (P = 0.002). Concerning contaminated surgery, significant differences were found in the rate of incidence of SSI (33.3% vs. 13.9%, P = 0.035). Compliance with the bundle of preoperative and intraoperative measures exceeded 95% and almost reached 50%, respectively. Compliance with the bundle of postoperative measures reached 25%.ConclusionsThis bundle has demonstrated to be effective in reducing the incidence of SSI in vascular surgery. The publication of these initial results should encourage the implementation of this bundle at national level.Copyright © 2017 Elsevier Inc. All rights reserved.

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