Impatto del cambiamento di alcune pratiche assistenziali sull'incidenza di infezioni della ferita chirurgica in seguito a interventi puliti

Translated title of the contribution: Impact of modifying patient-care practices on surgical wound infections (SWI) rates in clean operations

M. L. Moro, M. P. Carrieri, A. E. Tozzi, S. Lana, D. Greco, V. Beltrami, A. Caracino, M. Colombati, G. Di Croce, V. Iasonni, A. M. Napolitano, A. Pomidori, C. Vittorini, F. Amoroso, A. Colucci, A. R. Crafa, A. Guglielmi, C. Lombari, F. Mastandrea, G. PediciniP. Valitutti, M. Cagetti, G. Casula, G. Dettori, A. Liboni, R. Palomba, C. D. Pinna, M. Pisano, F. Pierdomenico, F. Palumbo, G. Sitzia

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives. To evaluate the changes in patient care practices following an intervention program in general surgery and their impact on surgical wound infections (SWI) associated with clean operations. Study design. A 'before-after' study design was used. Active surveillance was implemented in each ward; the intervention consisted of an educational program, whose effectiveness was evaluated comparing SWI rates before and after its implementation. Results. A total of 799 patients undergoing clean operations from three general surgical wards were included in the study: 606 before and 193 after the intervention program. The observed reduction in the SWI incidence was 79.2%; the most striking change in patient care practices observed after the intervention was the substitution of open surgical drains with closed drains. High risk operations (RR 8.4), length of operation greater than 2 hours (RR 11.2), and open surgical drains lasting more than three days (RR 5.1) significantly increased the risk of SWIs in the preintervention phase, according to the logistic regression analysis. Of the observed pre-intervention SWIs, 46.2% was attributable to exposure to open drains. Conclusions. Many postoperative infections can be prevented in environments where patient care practices fall well below the accepted standards. More efforts should be placed on the prevention of the risk associated with modifiable risk factors, such as open surgical drains.

Original languageItalian
Pages (from-to)61-67
Number of pages7
JournalMinerva Chirurgica
Volume52
Issue number1-2
Publication statusPublished - Jan 1997

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Surgical Wound Infection
Patient Care
Patients' Rooms
Program Evaluation
Logistic Models
Regression Analysis
Incidence
Infection

ASJC Scopus subject areas

  • Surgery

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Impatto del cambiamento di alcune pratiche assistenziali sull'incidenza di infezioni della ferita chirurgica in seguito a interventi puliti. / Moro, M. L.; Carrieri, M. P.; Tozzi, A. E.; Lana, S.; Greco, D.; Beltrami, V.; Caracino, A.; Colombati, M.; Di Croce, G.; Iasonni, V.; Napolitano, A. M.; Pomidori, A.; Vittorini, C.; Amoroso, F.; Colucci, A.; Crafa, A. R.; Guglielmi, A.; Lombari, C.; Mastandrea, F.; Pedicini, G.; Valitutti, P.; Cagetti, M.; Casula, G.; Dettori, G.; Liboni, A.; Palomba, R.; Pinna, C. D.; Pisano, M.; Pierdomenico, F.; Palumbo, F.; Sitzia, G.

In: Minerva Chirurgica, Vol. 52, No. 1-2, 01.1997, p. 61-67.

Research output: Contribution to journalArticle

Moro, ML, Carrieri, MP, Tozzi, AE, Lana, S, Greco, D, Beltrami, V, Caracino, A, Colombati, M, Di Croce, G, Iasonni, V, Napolitano, AM, Pomidori, A, Vittorini, C, Amoroso, F, Colucci, A, Crafa, AR, Guglielmi, A, Lombari, C, Mastandrea, F, Pedicini, G, Valitutti, P, Cagetti, M, Casula, G, Dettori, G, Liboni, A, Palomba, R, Pinna, CD, Pisano, M, Pierdomenico, F, Palumbo, F & Sitzia, G 1997, 'Impatto del cambiamento di alcune pratiche assistenziali sull'incidenza di infezioni della ferita chirurgica in seguito a interventi puliti', Minerva Chirurgica, vol. 52, no. 1-2, pp. 61-67.
Moro, M. L. ; Carrieri, M. P. ; Tozzi, A. E. ; Lana, S. ; Greco, D. ; Beltrami, V. ; Caracino, A. ; Colombati, M. ; Di Croce, G. ; Iasonni, V. ; Napolitano, A. M. ; Pomidori, A. ; Vittorini, C. ; Amoroso, F. ; Colucci, A. ; Crafa, A. R. ; Guglielmi, A. ; Lombari, C. ; Mastandrea, F. ; Pedicini, G. ; Valitutti, P. ; Cagetti, M. ; Casula, G. ; Dettori, G. ; Liboni, A. ; Palomba, R. ; Pinna, C. D. ; Pisano, M. ; Pierdomenico, F. ; Palumbo, F. ; Sitzia, G. / Impatto del cambiamento di alcune pratiche assistenziali sull'incidenza di infezioni della ferita chirurgica in seguito a interventi puliti. In: Minerva Chirurgica. 1997 ; Vol. 52, No. 1-2. pp. 61-67.
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abstract = "Objectives. To evaluate the changes in patient care practices following an intervention program in general surgery and their impact on surgical wound infections (SWI) associated with clean operations. Study design. A 'before-after' study design was used. Active surveillance was implemented in each ward; the intervention consisted of an educational program, whose effectiveness was evaluated comparing SWI rates before and after its implementation. Results. A total of 799 patients undergoing clean operations from three general surgical wards were included in the study: 606 before and 193 after the intervention program. The observed reduction in the SWI incidence was 79.2{\%}; the most striking change in patient care practices observed after the intervention was the substitution of open surgical drains with closed drains. High risk operations (RR 8.4), length of operation greater than 2 hours (RR 11.2), and open surgical drains lasting more than three days (RR 5.1) significantly increased the risk of SWIs in the preintervention phase, according to the logistic regression analysis. Of the observed pre-intervention SWIs, 46.2{\%} was attributable to exposure to open drains. Conclusions. Many postoperative infections can be prevented in environments where patient care practices fall well below the accepted standards. More efforts should be placed on the prevention of the risk associated with modifiable risk factors, such as open surgical drains.",
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author = "Moro, {M. L.} and Carrieri, {M. P.} and Tozzi, {A. E.} and S. Lana and D. Greco and V. Beltrami and A. Caracino and M. Colombati and {Di Croce}, G. and V. Iasonni and Napolitano, {A. M.} and A. Pomidori and C. Vittorini and F. Amoroso and A. Colucci and Crafa, {A. R.} and A. Guglielmi and C. Lombari and F. Mastandrea and G. Pedicini and P. Valitutti and M. Cagetti and G. Casula and G. Dettori and A. Liboni and R. Palomba and Pinna, {C. D.} and M. Pisano and F. Pierdomenico and F. Palumbo and G. Sitzia",
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T1 - Impatto del cambiamento di alcune pratiche assistenziali sull'incidenza di infezioni della ferita chirurgica in seguito a interventi puliti

AU - Moro, M. L.

AU - Carrieri, M. P.

AU - Tozzi, A. E.

AU - Lana, S.

AU - Greco, D.

AU - Beltrami, V.

AU - Caracino, A.

AU - Colombati, M.

AU - Di Croce, G.

AU - Iasonni, V.

AU - Napolitano, A. M.

AU - Pomidori, A.

AU - Vittorini, C.

AU - Amoroso, F.

AU - Colucci, A.

AU - Crafa, A. R.

AU - Guglielmi, A.

AU - Lombari, C.

AU - Mastandrea, F.

AU - Pedicini, G.

AU - Valitutti, P.

AU - Cagetti, M.

AU - Casula, G.

AU - Dettori, G.

AU - Liboni, A.

AU - Palomba, R.

AU - Pinna, C. D.

AU - Pisano, M.

AU - Pierdomenico, F.

AU - Palumbo, F.

AU - Sitzia, G.

PY - 1997/1

Y1 - 1997/1

N2 - Objectives. To evaluate the changes in patient care practices following an intervention program in general surgery and their impact on surgical wound infections (SWI) associated with clean operations. Study design. A 'before-after' study design was used. Active surveillance was implemented in each ward; the intervention consisted of an educational program, whose effectiveness was evaluated comparing SWI rates before and after its implementation. Results. A total of 799 patients undergoing clean operations from three general surgical wards were included in the study: 606 before and 193 after the intervention program. The observed reduction in the SWI incidence was 79.2%; the most striking change in patient care practices observed after the intervention was the substitution of open surgical drains with closed drains. High risk operations (RR 8.4), length of operation greater than 2 hours (RR 11.2), and open surgical drains lasting more than three days (RR 5.1) significantly increased the risk of SWIs in the preintervention phase, according to the logistic regression analysis. Of the observed pre-intervention SWIs, 46.2% was attributable to exposure to open drains. Conclusions. Many postoperative infections can be prevented in environments where patient care practices fall well below the accepted standards. More efforts should be placed on the prevention of the risk associated with modifiable risk factors, such as open surgical drains.

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KW - Prevention

KW - Surgical wound infections

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