525. Using a Multi-Faceted Active Change Process and Infection Prevention to Reduce Post Op C-Section Infections
Session: Poster Abstract Session: Surgical Site Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • Preventing CS SSI.pdf (565.2 kB)
  • Background: To describe a program this has successfully reduced SSIs. C-section patients have a five to twenty-fold greater risk for infection as compared to vaginal delivery. Surgical site Infection rates are estimated to be as high as 6.6%. A single readmission due to post-op infection can range from $5,000-$100,000.

    Methods: The site is an inner city women and newborn department doing 90-95 C-sections a month with a significant number of high risk patients.  A C-section Bundle was developed and implemented for all C-section patients. Inclusion Criteria for intervention: BMI>38 Diabetic with poor glucose control, large panus/evidence of skin breakdown, steroids, wound complications, >2 previous C-sections, keloid development, pregnancy induced hypertension (PIH), hemolysis, elevated liver enzymes, low platelet count (HELLP). Emergent patients: CHG scrub over the surgical site and blotted to dry by a sterile towel. Post op wound interventions: Dressings changed day three unless saturation required changing. Staples removed on day 7-10, not at discharge. Staples on obese patients stay in longer as needed. Negative pressure wound therapy for high risk patients.  

    Results: 83% infection reduction from January 2007 to December 2011. 92 post-op C-sections have been avoided since intervention yielding approximate cost savings of $4,600,000. (average of $50,000/readmission).

    Conclusion: Patient involvement is crucial for success. C-section SSI IS avoidable, even in high risk populations. It is hoped that studies of this type will allow for enhanced clinician education, patient safety and prove beneficial to facilities.

    David Brett, BS, BS, MS, Clinical Affairs, Smith & Nephew, St. Petersburg, FL


    D. Brett, Smith & Nephew: Employee and Shareholder, Salary

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.