Colorectal Session
AB046. 40. Should surgical site infection wound bundles become mandatory in colorectal surgery?—a meta-analysis
Deirdre Foley1,2, Michael Sugrue3, Madga Bucholc4, Randal Parlour5, Caroline McIntyre1,2, Alison Johnston1
1Donegal Clinical Research Academy, Letterkenny University Hospital, Letterkenny, Co Donegal, Ireland;2University College Dublin, Belfield Downs, Dublin, Ireland;3Department of Surgery, Letterkenny University Hospital, Letterkenny, Co Donegal, Ireland;4Intelligent Systems Research Centre, School of Computing, Engineering and Intelligent Systems, Magee Campus, Ulster University, Northern Ireland, UK;5Emergency Surgery Advancement Project (eSOAP), Letterkenny University Hospital, Letterkenny, Co Donegal, Ireland
Background: The global impact of surgical site infection (SSI) is increasingly recognized, both in terms of post-operative complications and oncological outcomes. Reducing SSIs is multi-factorial, with a cumulative additive benefit of each bundle element. While other meta-analyses have been performed looking at surgical wound bundles most relate to interventions before 2016. This study therefore undertook an up to date meta-analysis looking at existing bundle impact on SSIs.
Methods: An ethically approved PROSPERO-registered (ID: CRD42018104923) meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and using databases PubMed, Scopus and Web of Science, from January 2008 to July 2018, was undertaken. Articles scoring ≥17 using MINORS criteria were included.
Results: A total of 5,104 articles were reviewed and 27 studies met inclusion criteria. There was a significant decrease in SSI rates with implementation of a wound bundle (17.5% vs. 9.7%). Sub-analysis showed a significant reduction in superficial SSIs by 54% (P<0.00001) and in organ-space SSIs by 42% (P=0.0006). The use of a wound bundle also significantly reduced hospital lengths of stay (MD =−0.79; P<0.00001).
Conclusions: This meta-analysis shows that use of an evidence-based, surgical care wound bundle in patients undergoing colorectal surgery significantly reduces the risk of SSI and length of hospital stay. They should become mandatory.
Keywords: Colorectal surgery; prevention bundle; surgical site infections (SSI); surgical wound infection; wound bundles
doi: 10.21037/map.2019.AB046
Cite this abstract as: Foley D, Sugrue M, Bucholc M, Parlour R, McIntyre C, Johnston A. Should surgical site infection wound bundles become mandatory in colorectal surgery?—a meta-analysis. Mesentery Peritoneum 2019;3:AB046.
