Prevention Bundles for SSIs (PREBUSSI).

NCT ID: NCT05548764

Last Updated: 2023-12-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-10-01

Study Completion Date

2023-12-20

Brief Summary

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Surgical site infections (SSIs) are the most complication after a surgical operation and their incidence reaches 20% worldwide. SSIs have been associated to significant morbidity and mortality, high ICU admission rates, increased length of hospital stay, high readmission rates and raised cost. However, there is no registry for SSIs in Greece so far. In addition, it has been considered that almost half of SSIs could be prevented. Therefore, several prevention strategies have been suggested by international health organizations, such as WHO and NICE, that seem to be effective. The aim of the present study is to investigate the effect of 10 prevention bundles on the rate of SSIs, as well their consequences on several financial parameters of the Greek healthcare system.

Detailed Description

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* 1st phase (2 months) → SSIs rate among abdominal surgical operations and reporting of patients' demographics (gender, age, comorbidities), type of surgery (upper GI, HPB, colorectal), surgical approach (open, laparoscopic), urgency classification, operation time, cost, pathogen cultures and antibiotic sensitivity test.
* 2ο phase (10 months) → implementation of 10 prevention bundles:

1. Antibiotic delivery 1-1.5 hours before surgical incision and repeat every 4 hours intraoperatively.
2. Hair removal with electric hair clippers using single-use bladdes.
3. Surgical scrub with Povidone Iodine solution 4% (Betadine Surgical Scrub)
4. Skin preparation with chlorexidine alcohol-based antiseptic solution 2%.
5. Intraoperative and postoperative (4-6 hours) normothermia (\>36οC) using warmed forced-air blankets.
6. Perioperative normoglycemia (Glu\<200mg/dl) in diabetic patients.
7. Single-use drapes and gowns.
8. Surgical team glove changing by before skin incision closing.
9. Single-layer surgical incision closure with triclosan plus antimicrobial-coated sutures.
10. Wound irrigation (skin and subcutaneous fat) with Povidone Iodine solution (Betadine) after abdominal wall closure.
* Implementation check of 10 prevention bundles preoperatively, intraoperatively and postoperatively.
* Clinical assessment on POD 1, 3, 7 and 1 month postoperatively for SSI presence (according to WHO 2018 definition).
* Reporting of patients' demographics (gender, age, comorbidities), type of surgery (upper GI, HPB, colorectal), surgical approach (open, laparoscopic), urgency classification, operation time, length of stay, cost, pathogen cultures and antibiotic sensitivity test.

Conditions

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Surgical Site Infection

Keywords

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SSI prevention bundles PREBUSSI

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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Prevention Bundles

Patients in which prevention bundles for SSIs have been implemented.

Prevention Bundles for SSIs

Intervention Type PROCEDURE

10 preoperative, intraoperative and postoperative bundles that aim to decrease SSIs rate after their implementation in patients that underwent abdominal surgery.

No Prevention Bundles

Patients in which prevention bundles for SSIs have not been implemented.

No interventions assigned to this group

Interventions

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Prevention Bundles for SSIs

10 preoperative, intraoperative and postoperative bundles that aim to decrease SSIs rate after their implementation in patients that underwent abdominal surgery.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 18 years old
2. Signed consent from patient or authorized representative
3. Abdominal surgery
4. Open or laparoscopic operations

Exclusion Criteria

1. Age \< 18 years old
2. No signed consent from patient or authorized representative
3. Neck, thoracic, anal, lumbar operations
4. No closure of abdominal wall or open abdomen
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Maximos Frountzas

OTHER

Sponsor Role lead

Responsible Party

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Maximos Frountzas

Maximos Frountzas MD MPA PhD

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Konstantinos G Toutouzas, MD PhD

Role: PRINCIPAL_INVESTIGATOR

National and Kapodistrian University of Athens

Locations

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Hippocration General Hospital

Athens, , Greece

Site Status

Countries

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Greece

References

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Shrestha B, Dunn L. The Declaration of Helsinki on Medical Research involving Human Subjects: A Review of Seventh Revision. J Nepal Health Res Counc. 2020 Jan 21;17(4):548-552. doi: 10.33314/jnhrc.v17i4.1042.

Reference Type BACKGROUND
PMID: 32001865 (View on PubMed)

Suragul W, Rungsakulkij N, Vassanasiri W, Tangtawee P, Muangkaew P, Mingphruedhi S, Aeesoa S. Predictors of surgical site infection after pancreaticoduodenectomy. BMC Gastroenterol. 2020 Jun 26;20(1):201. doi: 10.1186/s12876-020-01350-8.

Reference Type BACKGROUND
PMID: 32586351 (View on PubMed)

Mentor K, Ratnayake B, Akter N, Alessandri G, Sen G, French JJ, Manas DM, Hammond JS, Pandanaboyana S. Meta-Analysis and Meta-Regression of Risk Factors for Surgical Site Infections in Hepatic and Pancreatic Resection. World J Surg. 2020 Dec;44(12):4221-4230. doi: 10.1007/s00268-020-05741-6. Epub 2020 Aug 18.

Reference Type BACKGROUND
PMID: 32812136 (View on PubMed)

Fuglestad MA, Tracey EL, Leinicke JA. Evidence-based Prevention of Surgical Site Infection. Surg Clin North Am. 2021 Dec;101(6):951-966. doi: 10.1016/j.suc.2021.05.027.

Reference Type BACKGROUND
PMID: 34774274 (View on PubMed)

Lohsiriwat V. High Compliance With Surgical Site Infection (SSI) Prevention Bundle Reduces Incisional SSI After Colorectal Surgery. Ann Coloproctol. 2021 Jun;37(3):146-152. doi: 10.3393/ac.2020.04.10.2. Epub 2020 May 15.

Reference Type BACKGROUND
PMID: 32674555 (View on PubMed)

Other Identifiers

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PREBUSSI 2022

Identifier Type: -

Identifier Source: org_study_id