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Reducing the risk of surgical site infections: did we really think SCIP was going to lead us to the promised land? Surg Infect (Larchmt) 2011 Jun;12(3):169-77

Date

07/20/2011

Pubmed ID

21767147

DOI

10.1089/sur.2011.036

Scopus ID

2-s2.0-80052761017   58 Citations

Abstract

BACKGROUND: Surgical site infections (SSIs) are associated with substantial patient morbidity and death. It is estimated that 750,000-1 million SSIs occur in the U.S. each year, utilizing 3.7 million extra hospital days and costing more than $1.6 billion in excess hospital charges.

METHOD: Review of pertinent English-language literature.

RESULTS: The Surgical Care Improvement Project (SCIP) was embraced as a "one-size-fits-all" strategy to reduce postoperative infectious morbidity 25% by 2010. Unfortunately, the evidence suggests that SCIP by itself has had little efficacy in reducing the overall risk of SSI. Whereas the SCIP initiative represents a first national effort to focus on reducing postoperative infectious morbidity and deaths, it fails to consider salient risk factors such as body mass index and selected surgical practices, including tourniquet application prior to incision.

CONCLUSION: Rather than focus on a single risk-reduction strategy, future efforts to improve surgical outcomes should embrace a "SCIP-plus" multi-faceted, tiered interventional strategy that includes pre-admission antiseptic showering, state-of-the-art skin antisepsis, innovative antimicrobial technology, active staphylococcal surveillance, and pharmacologic-physiologic considerations unique to selective patient populations.

Author List

Edmiston CE, Spencer M, Lewis BD, Brown KR, Rossi PJ, Henen CR, Smith HW, Seabrook GR

Authors

Kellie R. Brown MD Professor in the Surgery department at Medical College of Wisconsin
Brian D. Lewis MD Professor in the Surgery department at Medical College of Wisconsin
Peter J. Rossi MD Chief, Associate Professor in the Surgery department at Medical College of Wisconsin
Gary R. Seabrook MD Chief, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Guidelines as Topic
Humans
Infection Control
Risk Factors
Surgical Wound Infection
United States
jenkins-FCD Prod-398 336d56a365602aa89dcc112f077233607d6a5abc