Reducing the Risk of Surgical Site Infections: Did We Really Think SCIP Was Going to Lead Us to the Promised Land?

被引:58
作者
Edmiston, Charles E., Jr. [1 ,2 ]
Spencer, Maureen [3 ]
Lewis, Brian D.
Brown, Kellie R.
Rossi, Peter J.
Henen, Cindy R. [4 ]
Smith, Heidi W. [4 ]
Seabrook, Gary R.
机构
[1] Med Coll Wisconsin, Div Vasc Surg, Dept Surg, Milwaukee, WI 53226 USA
[2] Med Coll Wisconsin, Surg Microbiol Res Lab, Milwaukee, WI 53226 USA
[3] Universal Hlth Serv, King Of Prussia, PA USA
[4] Froedtert Hosp, Dept Pharm, Milwaukee, WI USA
关键词
RESISTANT STAPHYLOCOCCUS-AUREUS; STERNAL WOUND INFECTIONS; GLUCOSE CONTROL; GLOVE PERFORATION; CARE IMPROVEMENT; METHICILLIN RESISTANCE; BACTERIAL ADHERENCE; COATED SUTURES; MRSA; COLONIZATION;
D O I
10.1089/sur.2011.036
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Surgical site infections (SSIs) are associated with substantial patient morbidity and death. It is estimated that 750,000-1 million SSIs occur in the U. S. each year, utilizing 3.7 million extra hospital days and costing more than $1.6 billion in excess hospital charges. Method: Review of pertinent English-language literature. Results: The Surgical Care Improvement Project (SCIP) was embraced as a "one-size-fits-all'' strategy to reduce postoperative infectious morbidity 25% by 2010. Unfortunately, the evidence suggests that SCIP by itself has had little efficacy in reducing the overall risk of SSI. Whereas the SCIP initiative represents a first national effort to focus on reducing postoperative infectious morbidity and deaths, it fails to consider salient risk factors such as body mass index and selected surgical practices, including tourniquet application prior to incision. Conclusion: Rather than focus on a single risk-reduction strategy, future efforts to improve surgical outcomes should embrace a "SCIP-plus'' multi-faceted, tiered interventional strategy that includes pre-admission antiseptic showering, state-of-the-art skin antisepsis, innovative antimicrobial technology, active staphylococcal surveillance, and pharmacologic-physiologic considerations unique to selective patient populations.
引用
收藏
页码:169 / 177
页数:9
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