Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, Houston, Texas.
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, Houston, Texas.
Am J Infect Control. 2020 May;48(5):555-559. doi: 10.1016/j.ajic.2019.09.005. Epub 2019 Nov 7.
This study investigated cesarean delivery surgical site infection (SSI) rates before and after implementation of a SSI care bundle.
A SSI bundle for cesareans was introduced in our hospital in April 2014 to reduce the SSI rate. The practices were divided into bundle elements that reflected preoperative, intraoperative, and postoperative care. We conducted a retrospective cohort study to evaluate implementation of the SSI care bundle. Women were included if they had a gestational age of at least 23 0/7 weeks and delivered a liveborn neonate(s) between 2012 and 2015. They were then divided into 2 study groups: pre-bundle and post-bundle. The primary study outcome was SSI rate. Secondary outcomes included comorbidities, perioperative factors, and SSI classification.
The overall incidence of cesarean SSIs during the study time period was 1.89 (76 SSIs in 4014 cesarean deliveries). The pre-bundle mean was 2.44 and decreased to 1.1 following implementation of the SSI bundle (P = .013). This represents a 221% reduction in the SSI rate. Patient demographics and pre-existing medical conditions were similar pre- and post-bundle. Compliance with bundle elements was high.
A significant reduction in SSI rate in cesarean deliveries was seen following implementation of an infection prevention bundle.
本研究调查了实施手术部位感染（SSI）护理包前后剖宫产术 SSI 发生率。
2014 年 4 月，我院引入剖宫产术 SSI 护理包，以降低 SSI 发生率。这些措施分为反映术前、术中和术后护理的护理包元素。我们进行了一项回顾性队列研究，以评估 SSI 护理包的实施情况。如果孕妇的胎龄至少为 23 周零 7 天，且在 2012 年至 2015 年间分娩了活产新生儿，则将其纳入研究。然后，将其分为 2 个研究组：护理包实施前组和护理包实施后组。主要研究结果为 SSI 发生率。次要结局包括合并症、围手术期因素和 SSI 分类。
在研究期间，剖宫产术 SSI 的总发生率为 1.89%（4014 例剖宫产中有 76 例 SSI）。护理包实施前的平均值为 2.44%，实施后降至 1.1%（P=.013）。这代表 SSI 发生率降低了 221%。患者的人口统计学特征和合并症在护理包实施前后相似。护理包元素的遵守率很高。
实施感染预防包后，剖宫产术 SSI 发生率显著降低。
