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01-12-2015 | Hepatobiliary Tumors

Perioperative Bundle Decreases Postoperative Hepatic Surgery Infections

Authors: Maureen V. Hill, MD, Stefan D. Holubar, MD, MS, FACS, FASCRS, Catherine I. Garfield Legare, MHA, Christopher M. Luurtsema, MBA, Richard J. Barth Jr., MD, FACS

Published in: Annals of Surgical Oncology | Special Issue 3/2015

Abstract

Background

Postoperative infections are a costly and morbid complication. The introduction of perioperative infection prevention bundles have decreased surgical site infections (SSIs) in patients undergoing colorectal and pancreatic surgery.

Aim

The purpose of this study was to determine if the implementation of a perioperative bundle would reduce postoperative infectious complications in patients undergoing hepatic surgery.

Methods

An evidence-based, low cost, perioperative infection bundle was created, and a retrospective review of a prospectively maintained database was performed on 163 consecutive patients undergoing hepatic surgery. Patient characteristics, operative details, outcomes, and complications were reviewed, and differences pre- and post-bundle were assessed with univariate and multivariate analyses.

Results

A total of 113 patients received standard infection prophylaxis, while 50 received the perioperative bundle. Twenty-five patients had infections (16 deep abscesses, 3 superficial SSIs, 4 urinary tract infections, 1 pneumonia, 1 bacteremia). The overall infection rate decreased from 20.4 % (23/133) pre-bundle to 4 % (2/50) post-bundle. The SSI rate also decreased from 15 % (17/113) to 4 % (2/50). Univariate analysis showed that institution of the bundle was associated with a lower overall infection rate (p = 0.008), lower SSI rate (p = 0.06), and lower overall complication rate (p = 0.04). Multivariate analysis confirmed that the use of the bundle was independently associated with a lower infection (p = 0.008) and SSI (p = 0.05) rate. The primary length of stay (LOS) and LOS for 60 days postoperatively both significantly decreased post-bundle (from median of 5–4 days, p ≤ 0.001; 6–4 days, p ≤ 0.001).

Conclusions

Implementation of a perioperative infection prevention bundle significantly decreased overall infections, SSIs, and postoperative LOS in patients undergoing hepatic surgery.

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Title: Perioperative Bundle Decreases Postoperative Hepatic Surgery Infections
Authors: Maureen V. Hill, MD
Stefan D. Holubar, MD, MS, FACS, FASCRS
Catherine I. Garfield Legare, MHA
Christopher M. Luurtsema, MBA
Richard J. Barth Jr., MD, FACS
Publication date: 01-12-2015
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue Special Issue 3/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-015-4584-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perioperative Bundle Decreases Postoperative Hepatic Surgery Infections

Abstract

Background

Aim

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aim

Methods

Results

Conclusions

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