Vij SC, et al. - Researchers planned this study to reduce the superficial surgical site infection rate (sSSI) following major urologic surgery by implementing a simple operating room bundle. In this study, the introduction of a simple, fast, low-cost and easily reproducible bundle into the operating room resulted in a reduction in SSI rate after major urologic surgery. Thereby suggesting that this bundle is effective in reducing SSI which is critical for the patient and the physician in this era of public reporting and reimbursement based on outcomes.

Methods

• Researchers applied a simple operating room bundle to all major urologic cases (cystectomy, nephrectomy and prostatectomy) at a single tertiary referral center.
• This bundle comprised of allowing skin prep to dry appropriately, changing gloves prior to skin closure, irrigating the wound prior to skin closure and using a new separate sterile closing instrument set for skin closure.
• In addition, alcohol-based preps were introduced hospital-wide three months into the study period.
• They assessed the SSI rate from the NSQIP (National Surgical Quality Improvement Program) database.

Results

• After a 14-month study period, researchers assessed the SSI rate for a total of 510 cases.
• They analyzed 138 cases over a 3-month period with an SSI rate of 0% prior to instituting alcohol-based prep, but after the bundle was implemented.
• The infection rate was 1.37% (7/510) for the remaining 11 months with both the alcohol-based prep and infection prevention bundle in place compared to 3.57% (22/615) for the 12-month period prior to bundle introduction, a statistically significant reduction (p = 0.023).