Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
J Hosp Infect. 2013 Dec;85(4):282-8. doi: 10.1016/j.jhin.2013.08.002. Epub 2013 Sep 6.
Surgical site infection (SSI) is an ongoing major public health problem throughout the world that increases healthcare costs. Utilizing a methodology that can help clinicians to continuously collect data about SSIs, analyse it and implement the feedback into routine hospital practice has been identified as a top national priority in Japan.
To conduct an intervention study through 'operations research' using partitioning at multiple facilities, and to reduce the incidence and consequences of SSI.
The Setouchi SSI Surveillance Group, which consists of seven institutes, started SSI surveillance in 2006. Until May of 2008, there were four surveillance periods (A-D). In all, 3089 patients underwent gastrointestinal surgery and were followed up for 30 days after their operations. Twenty-six factors that have been reported to be related to SSI were evaluated for all patients. The top three factors from each surveillance period were determined and then actual practice improvements were planned for each subsequent period.
The total SSI occurrence was 6.9% for period A, 6.3% for period B, 6.4% for period C and 3.9% for period D. Comparing periods A and D, there was a statistical significance in the decrease of SSI occurrence (P = 0.012).
Using the results and partitioning analysis of active SSI surveillance to contribute to action plans for improving clinical practice was effective in significantly reducing SSIs.
手术部位感染（SSI）是全球范围内持续存在的重大公共卫生问题，增加了医疗保健成本。利用一种可以帮助临床医生持续收集 SSI 数据、分析数据并将反馈纳入常规医院实践的方法，已被确定为日本的国家首要任务之一。
通过在多个医疗机构进行“手术研究”干预研究，降低 SSI 的发生率和后果。
由七个机构组成的濑户内海 SSI 监测小组于 2006 年开始进行 SSI 监测。截至 2008 年 5 月，共进行了四个监测期（A-D）。共有 3089 名胃肠道手术患者接受了监测，并在手术后 30 天内进行了随访。对所有患者评估了 26 个已报道与 SSI 相关的因素。从每个监测期确定前三个因素，然后为随后的每个时期制定实际实践改进计划。
A 期总 SSI 发生率为 6.9%，B 期为 6.3%，C 期为 6.4%，D 期为 3.9%。比较 A 期和 D 期，SSI 发生率下降具有统计学意义（P=0.012）。
利用积极的 SSI 监测的结果和分区分析来促进改善临床实践的行动计划，可有效显著降低 SSI 的发生率。
