PMID- 33400250
OWN - NLM
STAT- MEDLINE
DCOM- 20211123
LR  - 20211123
IS  - 2038-3312 (Electronic)
IS  - 2038-131X (Linking)
VI  - 73
IP  - 6
DP  - 2021 Dec
TI  - The use of an implemented infection prevention bundle reduces the incidence of 
      surgical site infections after colorectal surgery: a retrospective single center 
      analysis.
PG  - 2113-2124
LID - 10.1007/s13304-020-00960-x [doi]
AB  - BACKGROUND: Surgical-site infections (SSIs) represent the most common 
      complications after colorectal surgery (CS). Role of preoperative administration 
      of oral antibiotic prophylaxis (OAP) and mechanical bowel preparation (MBP), 
      alone or in combination, in the prevention of SSIs after CS is debated. Aim of 
      this study was to assess the effect of the introduction of an Implemented 
      Infection Prevention Bundle (IIPB) in preventing SSIs in CS. METHODS: A group of 
      251 patients (Group 1) who underwent CS receiving only preoperative intravenous 
      antibiotic prophylaxis (IAP) was compared to a Group of 107 patients (Group 2) 
      who also received the IIPB. The IIPB consisted of the combination of oral 
      administrations of three doses of Rifaximin 400 mg and MBP the day before surgery 
      and in the administration of a cleansing enema the day of the surgical procedure. 
      RESULTS: At the univariate analysis, Group 2 showed significant lower rates of 
      wound infection (WI) (2.8% vs. 9.9%; p = 0.021) and anastomotic leakage (AL) 
      (2.8% vs. 14.7%; p = 0.001) with shorter hospital stay (5 vs. 6 days; 
      p < 0.0001). The probability of postoperative AL was lower in Group 2; patients 
      in this Group resulted protected from AL; a statistically significant Odds ratio 
      of 0.16 (CI 0.05-0.55 p = 0.0034) was found. In diabetic patients, that were at 
      higher risk of WI (OR 3.53, CI 1.49-8.35 p = 0.002), despite having any impact on 
      anastomotic dehiscence, the use of IIPB significantly reduced the rate of WI (0% 
      vs 28.1%; p = 0.01). CONCLUSION: The use of an IIPB significantly reduces rates 
      of SSIs and post-operative hospital stay after CS.
CI  - (c) 2021. Italian Society of Surgery (SIC).
FAU - Caputo, Damiano
AU  - Caputo D
AD  - Department of Surgery, University Campus Bio-Medico of Rome, Via Alvaro del 
      Portillo 200, 00128, Rome, Italy.
FAU - Coppola, Alessandro
AU  - Coppola A
AD  - Department of Surgery, University Campus Bio-Medico of Rome, Via Alvaro del 
      Portillo 200, 00128, Rome, Italy.
FAU - Farolfi, Tommaso
AU  - Farolfi T
AD  - Department of Surgery, University Campus Bio-Medico of Rome, Via Alvaro del 
      Portillo 200, 00128, Rome, Italy. t.farolfi@unicampus.it.
FAU - La Vaccara, Vincenzo
AU  - La Vaccara V
AD  - Department of Surgery, University Campus Bio-Medico of Rome, Via Alvaro del 
      Portillo 200, 00128, Rome, Italy.
FAU - Angeletti, Silvia
AU  - Angeletti S
AD  - Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome, Rome, 
      Italy.
FAU - Cascone, Chiara
AU  - Cascone C
AD  - Department of Surgery, University Campus Bio-Medico of Rome, Via Alvaro del 
      Portillo 200, 00128, Rome, Italy.
FAU - Ciccozzi, Massimo
AU  - Ciccozzi M
AD  - Unit of Medical Statistic and Molecular Epidemiology, University Campus 
      Bio-Medico of Rome, Rome, Italy.
FAU - Coppola, Roberto
AU  - Coppola R
AD  - Department of Surgery, University Campus Bio-Medico of Rome, Via Alvaro del 
      Portillo 200, 00128, Rome, Italy.
LA  - eng
PT  - Journal Article
DEP - 20210105
PL  - Italy
TA  - Updates Surg
JT  - Updates in surgery
JID - 101539818
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Anti-Bacterial Agents/therapeutic use
MH  - *Colorectal Surgery/adverse effects
MH  - Elective Surgical Procedures
MH  - Humans
MH  - Incidence
MH  - Preoperative Care
MH  - Retrospective Studies
MH  - *Surgical Wound Infection/epidemiology/prevention & control
OTO - NOTNLM
OT  - Anastomic leak
OT  - Antibiotic prophylaxis
OT  - Colorectal surgery
OT  - Mechanical bowel preparation
OT  - Prevention
OT  - Surgical site infections
EDAT- 2021/01/06 06:00
MHDA- 2021/11/24 06:00
CRDT- 2021/01/05 12:17
PHST- 2020/09/27 00:00 [received]
PHST- 2020/12/23 00:00 [accepted]
PHST- 2021/01/06 06:00 [pubmed]
PHST- 2021/11/24 06:00 [medline]
PHST- 2021/01/05 12:17 [entrez]
AID - 10.1007/s13304-020-00960-x [pii]
AID - 10.1007/s13304-020-00960-x [doi]
PST - ppublish
SO  - Updates Surg. 2021 Dec;73(6):2113-2124. doi: 10.1007/s13304-020-00960-x. Epub 
      2021 Jan 5.