Effect of a Surgical Care Bundle on the Incidence of Surgical Site Infection in Colorectal Surgery: A Quasi-Experimental Intervention

Rev Invest Clin. 2021 May 4;73(4):251-258. doi: 10.24875/RIC.21000067.

Abstract

Background: Surgical site infections (SSI) have an important impact on morbidity and mortality.

Objective: This study, therefore, sought to assess the effect of a surgical care bundle on the incidence of SSI in colorectal surgery.

Methods: We 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).

Results: A 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.

Conclusions: Care 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.

Keywords: Surgical site infection; Incidence; Care bundle; Colorectal surgery.

MeSH terms

  • Colorectal Surgery* / adverse effects
  • Humans
  • Incidence
  • Patient Care Bundles*
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection* / epidemiology
  • Surgical Wound Infection* / prevention & control