An Investigation of Cost-Effective Ways to Prevent Surgical Site Infections in Abdominal Surgery

Aware that SSIs contribute to more than a third of the annual costs expended for the treatment of hospital-acquired infections, health care systems are implementing preventative interventions. These include standardization of perioperative procedures and assembly of multidisciplinary teams in which members apply specialized knowledge and training to SSI prevention. Additionally, predictive methods for calculating patients’ risk for developing SSIs have been used to effectively prevent SSI development in a similar sense to universal hand hygiene protocols.

Diligent following of preoperative protocols can lead to dramatic reduction and potential cost saving of SSI-associated costs. Rosemurgy et al. (2018) found that the institution of a standardized protocol to reduce abdominal SSI reduced standardized operative costs from $40.85-$126.94 per patient, dependent on methicillin-resistant staphylococcus aureus screening results to $43.85 per patient after protocol institution. This saved each patient up to $83.09. The protocol also reduced SSI rates from 4.9% to 3.4%, saving the hospital $166,280. Leaper et al. (2017) found that the use of antimicrobial suture led to significant savings across multiple surgical wound types. They found that the mean SSIs saving per procedure when triclosan coated or impregnated (TCS) sutures were used in contrast to the convention non-antimicrobial-coated absorbable sutures (NCS) were £91.25, or 90% across all wound types.

Preoperative measures for preventing SSIs include early ambulation, patient education on preventing infections, and at least one preoperative bath with antimicrobial or non-antimicrobial soap for patients planned to undergo surgery (Edmiston et al. 2015). Combining oral antibiotic preparation and mechanical bowel preparation for all colorectal surgeries in adults (Nelson et al. 2014) is recommended. Others include methicillin-resistant s. aureus screening and decolonization (Pofahl et al. 2009; Allegranzi et al. 2016), when preparing for forearm or hand surgery, unless contraindicated, use alcohol-based skin disinfectants (Anderson et al., 2014),, antimicrobial prophylaxis (Zhang et al. 2020), nutritional preparation, and preoperative HbA1C less than 8% (Han & Kang, 2013).

 

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