Cardiothoracic Interdisciplinary Research Network, Leicester Clinical Trials Unit, University of Leicester, Leicester, UK.
National Cardiac Benchmarking Collaborative, Oxford, UK.
J Hosp Infect. 2020 Dec;106(4):812-819. doi: 10.1016/j.jhin.2020.09.016. Epub 2020 Sep 19.
Currently no national standards exist for the prevention of surgical site infection (SSI) in cardiac surgery. SSI rates range from 1% to 8% between centres.
The aim of this study was to explore and characterize variation in approaches to SSI prevention in the UK and the Republic of Ireland (ROI).
Cardiac surgery centres were surveyed using electronic web-based questionnaires to identify variation in SSI prevention at the level of both institution and consultant teams. Surveys were developed and undertaken through collaboration between the Cardiothoracic Interdisciplinary Research Network (CIRN), Public Health England (PHE) and the National Cardiac Benchmarking Collaborative (NCBC) to encompass routine pre-, intra- and postoperative practice.
Nineteen of 38 centres who were approached provided data and included responses from 139 consultant teams. There was no missing data from those centres that responded. The results demonstrated substantial variation in over 40 aspects of SSI prevention. These included variation in SSI surveillance, reporting of SSI infection rates to external bodies, utilization of SSI risk prediction tools, and the use of interventions such as sternal support devices and gentamicin impregnated sponges.
Measured variation in SSI prevention in cardiac centres across the UK and ROI is evidence of clinical uncertainty as to best practice, and has identified areas for quality improvement as well as knowledge gaps to be addressed by future research.
目前，心脏外科手术部位感染（SSI）的预防尚无国家标准。中心之间的 SSI 发生率在 1%至 8%之间。
本研究旨在探讨和描述英国和爱尔兰共和国（ROI）心脏外科手术预防 SSI 的方法差异。
使用电子网络问卷对心脏外科中心进行调查，以确定机构和顾问团队在 SSI 预防方面的差异。调查是通过心胸科跨学科研究网络（CIRN）、英国公共卫生署（PHE）和国家心脏基准协作（NCBC）之间的合作开发和进行的，涵盖了术前、术中和术后的常规实践。
在 38 个被调查的中心中，有 19 个提供了数据，并包括了 139 个顾问团队的回应。对回复的中心没有缺失数据。结果显示，在超过 40 个 SSI 预防方面存在大量差异。这些差异包括 SSI 监测、向外部机构报告 SSI 感染率、使用 SSI 风险预测工具以及使用胸骨支撑装置和庆大霉素浸渍海绵等干预措施。
英国和 ROI 心脏中心在 SSI 预防方面的测量差异表明，在最佳实践方面存在临床不确定性，并确定了质量改进领域以及未来研究需要解决的知识差距。
