Hospital Reduces Hysterectomy SSIs With Prevention Bundle

A Connecticut hospital significantly decreased surgical site infections associated with hysterectomies through the use of a multi-step prevention bundle, according to a study published in Obstetrics & Gynecology and Medscape report on the research.

The bundle included the following components:

• chlorhexidine-impregnated preoperative wipes provided to patients;
• standardized aseptic surgical preparation of the abdomen, vagina, and perineum;
• standardized antibiotic dosing before and during surgery;
• maintenance of intraoperative normothermia;
• surgical dressing maintenance 24 to 48 hours postoperatively; and
• provision of direct feedback from peers to physicians and other staff when the protocol was breached.

Hospital staff received education about the bundle prior to its implementation.

During the 33-month study period, Yale New Haven Hospital in New Haven, Conn., performed 2,099 hysterectomies. There were 61 SSIs (4.51%) prior to implementation of the full bundle and 14 SSIs (1.87%) following implementation of the full bundle.

According to the Medscape report, the authors concluded the following: "Although additional analyses are needed to further elucidate the relationships among adherence rates, specific bundle components, hysterectomy routes, length of hospital stay and [SSI] reduction and overall surgical costs, we believe that a multidisciplinary, gynecology-specific approach to implementation and maintenance of the SSI prevention bundle serves patients well and will become a mainstay of gynecologic surgical care."