Abdominal closure protocol in colorectal, gynecologic oncology, and urology procedures: A randomized quality improvement trial

Mary R. Kwaan, Christopher J. Weight, Stacy Jo Carda, Alyssia Mills-Hokanson, Elizabeth Wood, Colleen Rivard-Hunt, Peter A. Argenta

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Prevention of surgical site infections (SSIs) can improve surgical quality through reductions in morbidity and cost. We sought to determine whether the abdominal closure protocol, in isolation, decreases SSI at an academic teaching hospital. Methods Adult patients undergoing laparotomy were prospectively randomized to an abdominal closure protocol, which includes unused sterile instruments and equipment at fascial closure, or usual care. A 30-day SSI rates were compared. General surgery, colorectal, urology, or gynecologic oncology patients undergoing anticipated wound classification II cases were eligible. Results Overall SSI rates were 11.6% in patients randomized to protocol closure vs 12.4% for usual care (total n = 233; P =.85). The abdominal closure protocol and usual care groups had similar rates of superficial (4.5% vs 4.1%; P =.9), deep (.9% vs 0%, P =.3), organ-space SSI rates (6.2% vs 8.3%, P =.55), and wound dehiscence (2.7% vs 5.3%; P =.24). Conclusions An abdominal closure protocol did not decrease the rate of SSI and is likely not a key intervention for SSI reduction.

Original languageEnglish (US)
Pages (from-to)1077-1083
Number of pages7
JournalAmerican journal of surgery
Volume211
Issue number6
DOIs
StatePublished - Jun 1 2016

Fingerprint

Surgical Wound Infection
Urology
Quality Improvement
Wounds and Injuries
Teaching Hospitals
Laparotomy
Morbidity
Costs and Cost Analysis
Equipment and Supplies

Keywords

  • Closing tray
  • Colectomy
  • Hysterectomy
  • Perioperative
  • Surgical site infection
  • Urinary conduit

Cite this

Abdominal closure protocol in colorectal, gynecologic oncology, and urology procedures : A randomized quality improvement trial. / Kwaan, Mary R.; Weight, Christopher J.; Carda, Stacy Jo; Mills-Hokanson, Alyssia; Wood, Elizabeth; Rivard-Hunt, Colleen; Argenta, Peter A.

In: American journal of surgery, Vol. 211, No. 6, 01.06.2016, p. 1077-1083.

Research output: Contribution to journalArticle

Kwaan, Mary R. ; Weight, Christopher J. ; Carda, Stacy Jo ; Mills-Hokanson, Alyssia ; Wood, Elizabeth ; Rivard-Hunt, Colleen ; Argenta, Peter A. / Abdominal closure protocol in colorectal, gynecologic oncology, and urology procedures : A randomized quality improvement trial. In: American journal of surgery. 2016 ; Vol. 211, No. 6. pp. 1077-1083.
@article{f48a5d3737554043b3ed7c645ffaa8d8,
title = "Abdominal closure protocol in colorectal, gynecologic oncology, and urology procedures: A randomized quality improvement trial",
abstract = "Background Prevention of surgical site infections (SSIs) can improve surgical quality through reductions in morbidity and cost. We sought to determine whether the abdominal closure protocol, in isolation, decreases SSI at an academic teaching hospital. Methods Adult patients undergoing laparotomy were prospectively randomized to an abdominal closure protocol, which includes unused sterile instruments and equipment at fascial closure, or usual care. A 30-day SSI rates were compared. General surgery, colorectal, urology, or gynecologic oncology patients undergoing anticipated wound classification II cases were eligible. Results Overall SSI rates were 11.6{\%} in patients randomized to protocol closure vs 12.4{\%} for usual care (total n = 233; P =.85). The abdominal closure protocol and usual care groups had similar rates of superficial (4.5{\%} vs 4.1{\%}; P =.9), deep (.9{\%} vs 0{\%}, P =.3), organ-space SSI rates (6.2{\%} vs 8.3{\%}, P =.55), and wound dehiscence (2.7{\%} vs 5.3{\%}; P =.24). Conclusions An abdominal closure protocol did not decrease the rate of SSI and is likely not a key intervention for SSI reduction.",
keywords = "Closing tray, Colectomy, Hysterectomy, Perioperative, Surgical site infection, Urinary conduit",
author = "Kwaan, {Mary R.} and Weight, {Christopher J.} and Carda, {Stacy Jo} and Alyssia Mills-Hokanson and Elizabeth Wood and Colleen Rivard-Hunt and Argenta, {Peter A.}",
year = "2016",
month = "6",
day = "1",
doi = "10.1016/j.amjsurg.2015.10.032",
language = "English (US)",
volume = "211",
pages = "1077--1083",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Abdominal closure protocol in colorectal, gynecologic oncology, and urology procedures

T2 - A randomized quality improvement trial

AU - Kwaan, Mary R.

AU - Weight, Christopher J.

AU - Carda, Stacy Jo

AU - Mills-Hokanson, Alyssia

AU - Wood, Elizabeth

AU - Rivard-Hunt, Colleen

AU - Argenta, Peter A.

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Background Prevention of surgical site infections (SSIs) can improve surgical quality through reductions in morbidity and cost. We sought to determine whether the abdominal closure protocol, in isolation, decreases SSI at an academic teaching hospital. Methods Adult patients undergoing laparotomy were prospectively randomized to an abdominal closure protocol, which includes unused sterile instruments and equipment at fascial closure, or usual care. A 30-day SSI rates were compared. General surgery, colorectal, urology, or gynecologic oncology patients undergoing anticipated wound classification II cases were eligible. Results Overall SSI rates were 11.6% in patients randomized to protocol closure vs 12.4% for usual care (total n = 233; P =.85). The abdominal closure protocol and usual care groups had similar rates of superficial (4.5% vs 4.1%; P =.9), deep (.9% vs 0%, P =.3), organ-space SSI rates (6.2% vs 8.3%, P =.55), and wound dehiscence (2.7% vs 5.3%; P =.24). Conclusions An abdominal closure protocol did not decrease the rate of SSI and is likely not a key intervention for SSI reduction.

AB - Background Prevention of surgical site infections (SSIs) can improve surgical quality through reductions in morbidity and cost. We sought to determine whether the abdominal closure protocol, in isolation, decreases SSI at an academic teaching hospital. Methods Adult patients undergoing laparotomy were prospectively randomized to an abdominal closure protocol, which includes unused sterile instruments and equipment at fascial closure, or usual care. A 30-day SSI rates were compared. General surgery, colorectal, urology, or gynecologic oncology patients undergoing anticipated wound classification II cases were eligible. Results Overall SSI rates were 11.6% in patients randomized to protocol closure vs 12.4% for usual care (total n = 233; P =.85). The abdominal closure protocol and usual care groups had similar rates of superficial (4.5% vs 4.1%; P =.9), deep (.9% vs 0%, P =.3), organ-space SSI rates (6.2% vs 8.3%, P =.55), and wound dehiscence (2.7% vs 5.3%; P =.24). Conclusions An abdominal closure protocol did not decrease the rate of SSI and is likely not a key intervention for SSI reduction.

KW - Closing tray

KW - Colectomy

KW - Hysterectomy

KW - Perioperative

KW - Surgical site infection

KW - Urinary conduit

UR - http://www.scopus.com/inward/record.url?scp=84956660915&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84956660915&partnerID=8YFLogxK

U2 - 10.1016/j.amjsurg.2015.10.032

DO - 10.1016/j.amjsurg.2015.10.032

M3 - Article

C2 - 26850135

AN - SCOPUS:84956660915

VL - 211

SP - 1077

EP - 1083

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

IS - 6

ER -