Surgical Site Infection: Still Waiting on the Revolution

Anthony et al determine if an evidenced-based practice bundle would result in a significantly lower rate of surgical site infections (SSIs) when compared with standard practice. The overall rate of SSI was 45% in the extended arm of the study and 24% in the standard arm (P=.003). Most of the increas...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2011-04, Vol.305 (14), p.1478-1479
Main Authors: ANTHONY, Thomas, MURRAY, Bryce W, SUM-PING, John T, LENKOVSKY, Fima, VORNIK, Vadim D, PARKER, Betty J, MCFARLIN, Jackie E, HARTLESS, Kathleen, HUERTA, Sergio
Format: Article
Language:English
Subjects:
Abdominal surgery
Biological and medical sciences
Clinical outcomes
Evidence-based medicine
General aspects
Human infectious diseases. Experimental studies and models
Infections
Infectious diseases
Medical sciences
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Summary:Anthony et al determine if an evidenced-based practice bundle would result in a significantly lower rate of surgical site infections (SSIs) when compared with standard practice. The overall rate of SSI was 45% in the extended arm of the study and 24% in the standard arm (P=.003). Most of the increased number of infections in the extended arm were superficial incisional SSIs (36% extended arm vs 19% standard arm; P=.004). Multivariate analysis suggested that allocation to the extended arm of the trial conferred a 2.49-fold risk (95% confidence interval, 1.36-4.56; P=.003) independent of other factors traditionally associated with SSI. An evidenced-based intervention bundle did not reduce SSIs. The bundling of interventions, even when the constituent interventions have been individually tested, does not have a predictable effect on outcome. Formal testing of bundled approaches should occur prior to implementation.
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2011.447