Colon and rectal surgery surgical site infection reduction bundle: To improve is to change

Background: Despite the introduction of the Surgical Care Improvement Project, surgical site infections remain a source of morbidity. The aim of this study was to determine the value of implementing a colorectal bundle on SSI rates. Methods: Between 2011 and 2016 a total of 1351 patients underwent colorectal operations. Patients were grouped into pre-implementation (Group A, January 1, 2011-December 31, 2012), implementation (Group B, January 1, 2013-December 31, 2014) and post-implementation (Group C, January 1, 2015 -December 31, 2016). Primary endpoints were superficial SSI, deep SSI, wound separation and total SSI. Results: After the bundle was implemented, there was a significant reduction in superficial (6.6%-4%, p <0.05), deep (3.7%-1.1%, p <0.05), and total SSI rates (10.9%-4.7%, p <0.05). Comparing Group A to Group C there was a decrease in total SSI (9.4%-4.7%, p <0.05). Conclusion: Implementation of the bundle resulted in a reduction in overall SSI rates particularly as compliance increased. This study offers evidence that small changes can lead to significant decreases in surgical site infections. (C) 2018 Elsevier Inc. All rights reserved.