Reducing SSI In Colectomy Procedures
The MSQC is dedicated to improving the quality of patient care processes and outcomes. Surgical site infection (SSI) is the most common nosocomial infection and contributes substantially to a patient’s morbidity and mortality after surgery. SSI drastically elevates costs by increasing lengths of postoperative hospital stay, elevating rates of readmission and threatening health outcomes. The first step in the treatment of SSIs is prevention. MSQC has developed a data-driven process care bundle focused on SSI prevention for colectomy procedures. Supported by numerous research findings, implementation of the bundle is associated with a decrease in SSI (see reference #9 below).
View the MSQC Colectomy Bundle Implementation Tool below or click here to download and print.
SSI Prevention Practices
MSQC Colectomy Bundle Implementation Tool
References and Resources
Mechanical Bowel Prep
(1) Anjum, N., Ren J., Wang, G., Li, G., Wu, X., Dong, H., . . . Li, J. (2017). A Randomized Control Trial of Preoperative Oral Antibiotics as Adjunct Therapy to Systemic Antibiotics for Preventing Surgical Site Infection in Clean Contaminated, Contaminated, and Dirty Type of Colorectal Surgeries. Disease of the Colon & Rectum, 60(12), 1291-1298. doi: http://dx.doi.org/10.1097/DCR.0000000000000927
(2) Hjelmaas, A., Kanters, A., Anand, R., Cedarbaum., J., Chen, Y., Ly, L., . . . Regenbogen, S. (2018). 28.08 Bowel Preparation with Antibiotics Decreases Surgical-Site Infection for Both Left & Right Colectomy [Abstract]. Retrieved from http://www.asc-abstracts.org/abs2018/28-08-bowel-preparation-with-antibiotics-decreases-surgical-site-infection-for-both-left-right-colectomy/
Appropriate Prophylactic IV Antibiotics
(3) Bratzler, D., Dellinger, E., Olsen, K., Perl, T., Auwaerter, M., Bolon, M., . . . Weinstein, R. (2013). Clinical practice guidelines for antimicrobial prophylaxis in surgery. American Journal of Health-System Pharmacy, 70(3), 195-283. doi:
http://dx.doi.org/10.2146/ajhp120568
(4) Hendren, S., Fritze, D., Banerjee, M., Kubus, J., Cleary, R., Englesbe, M., Campbell, D. (2013). Antibiotic Choice Is Independently Associated with Risk of Surgical Site Infection After Colectomy: A Population-Based Cohort Study. Annals of Surgery, 257(3), 469-475. doi: http://dx.doi.org/10.1097/SLA.0b013e31826c4009
Glucose Management
(5) Duggan, E., Carlson, K., Umpierrez, G. (2017). Perioperative Hyperglycemia Management: An Update. Anesthesiology, 126(3), 547-560. doi: http://dx.doi.org/10.1097/ALN.0000000000001515
(6) Kiran, R., Turina, M., Hammel, J., Fazio, V. (2013). The Clinical Significance of an Elevated Postoperative Glucose Value in Nondiabetic Patients after Colorectal Surgery: Evidence for the Need for Tight Glucose Control? Annals of Surgery, 258(4), 599-605. doi: http://dx.doi.org/10.1097/SLA.0b013e3182a501e3
(7) Thompson, R., Broussard, E., Flum, D., Wisse, B. (2016). Perioperative Glycemic Control During Colorectal Surgery. Hospital Management of Diabetes, 16(32). doi: http://dx.doi.org/10.1007/s11892-016-0722-x
(8) Takesue Y, Tsuchida T. (2017). Strict glycemic control to prevent surgical site infections in gastroenterological surgery. Ann Gastroenterol Surg, 1, 52–59. doi: http://dx.doi.org/10.1002/ags3.12006
Colectomy Bundle
(9) Vu, J., Collins, S., Seese, E., Hendren, S., Englesbe, M., Campbell, D., Krapohl, G. (2018). Evidence that a Regional Surgical Collaborative Can Transform Care: Surgical Site Infection Prevention Practices for Colectomy in Michigan. Journal of the American College of Surgeons, 226(1), 91-99. doi:
http://dx.doi.org/10.1016/j.jamcollsurg.2017.10.013
(10) Waits, S. A., Fritze, D., Banerjee, M., Zhang, W., Kubus, J., Englesbe, M. J., . . . Hendren, S. (2014). Developing an argument for bundled interventions to reduce surgical site infection in colorectal surgery. Surgery, 155(4), 602-606. doi: