The American Journal of Surgery
Volume 198, Issue 2 , Pages 157-162, August 2009

Impact of intraoperative behavior on surgical site infections

Presented at the Annual Meeting of the Swiss Association of Surgery, Lausanne, Switzerland, June 13, 2007.

  • Guido Beldi, M.D.

      Affiliations

    • Department of Visceral and Transplant Surgery, Bern, Switzerland
    • Corresponding Author InformationCorresponding author. Tel.: +41-31-632-8275; fax: +41-382-4772
    • ,
  • Sonja Bisch-Knaden, Ph.D.

      Affiliations

    • Department of Visceral and Transplant Surgery, Bern, Switzerland
    • ,
  • Vanessa Banz, M.D.

      Affiliations

    • Department of Visceral and Transplant Surgery, Bern, Switzerland
    • ,
  • Kathrin Mühlemann, M.D., Ph.D.

      Affiliations

    • Institute of Infectious Diseases, Bern, Switzerland
    • ,
  • Daniel Candinas, M.D.

      Affiliations

    • Department of Visceral and Transplant Surgery, Bern, Switzerland

Received 25 July 2008; received in revised form 4 September 2008 published online 16 March 2009.

Abstract 

Background

The aim of this study was to identify intraoperative risk factors for surgical site infections (SSIs), which are accessible to interventions. We evaluated the effect of extensive intraoperative antiseptic measures and the impact of the behavior of members of the surgical team on SSIs.

Methods

Standard versus extensive antiseptic measures were randomly assigned in 1,032 surgical patients. The adherence to principles of asepsis by members of the surgical team was assessed prospectively.

Results

The rate of SSI was 14% with standard antiseptic measures and 15% with extensive measures (P = .581). Multivariate analysis identified following independent risk factors: lapses in discipline (odds ratio [OR] 2.02, confidence interval [CI] 1.05–3.88), intestinal anastomosis (OR 6.74, CI 3.42–13.30), duration of operation more than 3 hours (OR 3.34, CI 1.82–6.14), and body mass index >30 kg/m2 (OR 1.98, CI 1.22–3.20).

Conclusion

Extensive measures of antisepsis did not reduce the incidence of SSI. A lapse to adhere to principles of asepsis was identified as an independent risk factor for the development of SSI (ClinicalTrials.gov number, NCT00555815).

Keywords: Surgical site infection, Surgical team members, Aseptic measures, Behavior

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PII: S0002-9610(08)00896-9

doi:10.1016/j.amjsurg.2008.09.023

The American Journal of Surgery
Volume 198, Issue 2 , Pages 157-162, August 2009

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