Prevention of surgical site infection in colorectal surgery

The rate of surgical site infection (SSI) for colorectal surgery is among the highest of all operations performed, ranging between 12 and 26% depending on definition applied, surveillance, the prevalence of emergency surgery and the penetration of laparoscopic surgery. With over 135,000 colorectal cancer operations per year, the cost of SSI to the healthcare system are in excess of US$1 billion a year. The Surgical Care Improvement Project (SCIP) has linked hospital reimbursement to compliance with five preventative process measures in colorectal surgery. The success of SCIP in reducing SSI is in doubt, but the addition of other evidence-based measures to SCIP might improve SSI rates. These measures, as well as the contributions of SCIP, are discussed in detail in this review. Implementation of some or all these measures, in addition to SCIP, should be considered by key stakeholders for baseline data collection, monitored for effectiveness and modified as necessary to improve outcomes.

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