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
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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 -