Highlights
- •4560 patients underwent general, orthopedic trauma and vascular surgery procedures.
- •Teaching procedures were not independently associated with the odds of SSI.
- •Surgeons’ seniority and experience were not independently associated with SSI.
Abstract
Background/aim
To investigate whether teaching procedures and surgical experience are associated
with surgical site infection (SSI) rates.
Methods
This prospective cohort study of patients undergoing general, orthopedic trauma and
vascular surgery procedures was done between 2012 and 2015 at two tertiary care hospitals
in Switzerland/Europe.
Results
Out of a total of 4560 patients/surgeries, 1403 (30.8%) were classified as teaching
operations. The overall SSI rate was 5.1% (n = 233). Teaching operations (OR 0.78,
95% CI 0.57–1.07, p = 0.120), junior surgeons (OR 0.80, 95% CI 0.55–1.15, p = 0.229)
and surgical experience (OR 0.997, 95% CI 0.982–1.012, p = 0.676) were overall not
independently associated with the odds of SSI. However, for surgeons’ seniority and
experience, these associations depended on the duration of surgery.
Conclusions
In procedures of shorter and medium duration, teaching procedures and junior as well
as less experienced surgeons are not independently associated with increased odds
of SSI.
Keywords
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References
- Effect of reducing interns’ work hours on serious medical errors in intensive care units.N Engl J Med. 2004; 351 (PubMed PMID: 15509817): 1838-1848
- Adverse impact of surgical site infections in English hospitals.J Hosp Infect. 2005; 60 (PubMed PMID: 15866006): 93-103
- Economic burden of surgical site infections at a European university hospital.Infect Control Hosp Epidemiol. 2008; 29 (PubMed PMID: 18564917): 623-629
- Safety of teaching laparoscopic cholecystectomy to surgical residents.J Laparoendosc Adv Surg Tech. 1993; 3 (PubMed PMID: 8453124): 23-26
- Does the level of experience of residents affect outcomes of coronary artery bypass surgery?.Ann Thorac Surg. 2009; 87 (discussion 33-4. PubMed PMID: 19324138): 1127-1133
- Resident versus no resident: a single institutional study on operative complications, mortality, and cost.Surgery. 2008; 144 (PubMed PMID: 18656644): 339-344
- Surgical resident supervision in the operating room and outcomes of care in Veterans Affairs hospitals.Am J Surg. 2005; 190 (PubMed PMID: 16226948): 725-731
- Trainee surgeons do not cause more conversions in laparoscopic colorectal surgery if they are well supervised.World J Surg. 2009; 33 (PubMed PMID: 19727935): 2439-2443
- Resident participation does not affect surgical outcomes, despite introduction of new techniques.J Am Coll Surg. 2010; 211: 540-545
- Teaching colorectal surgery in the laparoscopic era; is it safe?.J Surg Educ. 2010; 67 (PubMed PMID: 20816356): 217-221
- Prevention and control of surgical site infections: review of the Basel Cohort Study.Swiss Med Wkly. 2012; 142 (PubMed PMID: 22949137): 1-9
- Impact of surgical training on incidence of surgical site infection.World J Surg. 2009; 33 (PubMed PMID: 19363694): 1165-1173
- Effects of surgical laparoscopic experience on the short-term postoperative outcome of rectal cancer: results of a high volume single center institution.Surg Laparosc Endosc Percutaneous Tech. 2010; 20 (PubMed PMID: 20393335): 93-99
- Influence of resident and attending surgeon seniority on operative performance in laparoscopic cholecystectomy.J Surg Res. 2006; 132 (PubMed PMID: 16412471): 159-163
- Laparoscopic appendectomy by residents: evaluating outcomes and learning curve.Surg Endosc. 2010; 24 (PubMed PMID: 19760332): 125-130
- Patient outcomes for segmental colon resection according to surgeon’s training, certification, and experience.Surgery. 2002; 132: 663-672
- Do new surgeons have higher surgical-site infection rates?.Infect Control Hosp Epidemiol. 2001; 22 (PubMed PMID: 11519916): 375-377
- Impact of intraoperative behavior on surgical site infections.Am J Surg. 2009; 198 (PubMed PMID: 19285307): 157-162
- Surgical wound infection rates by wound class, operative procedure, and patient risk index.Am J Med. 1991; 91 (PubMed PMID: 1656747)
- Duration of operation as a risk factor for surgical site infection: comparison of English and US data.J Hosp Infect. 2006; 63 (PubMed PMID: 16698117): 255-262
- Timing of surgical antimicrobial prophylaxis: a phase 3 randomised controlled trial.Lancet Infect Dis. 2017; 17: 605-614
- Evaluating the optimal timing of surgical antimicrobial prophylaxis: study protocol for a randomized controlled trial.Trials. 2014; 15 (PubMed PMID: 24885132): 188
- Guideline for prevention of surgical site infection.Hosp Infect Control Hosp Epidemiol Control. 1999; 20 (1999): 250-278
- Generalized estimating equations in longitudinal data analysis: a review and recent developments.Adv Stat. 2014; : 1-11
- Zelig: Everyone’s Statistical Software.2017 (Version 5.1-2)
- Toward A common framework for statistical analysis and development.J Comput Graph Stat. 2008; 17 (1{∖textendash}22)
- A Language and Environment for Statistical Computing.R Foundation for Statistical Computing, Vienna, Austria2017
- Computers and virtual reality for surgical education in the 21st century.Arch Surg. 2000; 135 (PubMed PMID: 10896371): 786-792
- Comparison of Canadian and Swiss surgical training curricula : moving on toward competency-based surgical education.J Surg Educ. 2017; 74: 37-46
Article info
Publication history
Published online: December 31, 2019
Accepted:
December 30,
2019
Received in revised form:
December 25,
2019
Received:
August 23,
2019
Identification
Copyright
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