Tackling Surgical Site Infections - Clinicians Call For Realistic Targets To Combat Unmet Needs

Main Category: MRSA / Drug Resistance
Also Included In: Dermatology;  Infectious Diseases / Bacteria / Viruses
Article Date: 16 Nov 2007 - 11:00 PDT

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Leading experts have agreed that Surgical Site Infections ("SSIs") continue to present a significant burden for patients and healthcare services, with new and effective strategies to reduce this burden are greatly needed. An expert group of over 20 renowned clinicians and researchers met recently over a two-day period in Reykjavik, Iceland, to discuss the unmet needs of patients and debate what changes could be introduced to reduce the occurrence of SSIs.

As part of the meeting, 'New non-pharmaceutical ways to reduce SSIs', attendees discussed SSIs rates and current SSIs targets whilst agreeing that although SSIs rates would ideally be zero, overriding factors such as age, disease status and type of surgery mean that this is not a realistic target. Overall, across a range of surgery types experts believed that an SSI rate of 0.7% - 1% should be realistic and that this should be considered by healthcare institutions in future.

The participating clinicians had spent time discussing what practical changes to the surgical procedures could be made to reduce or, indeed, prevent SSIs, focusing particularly on the following points:

- improve hospital discharge follow-up procedures (it was agreed that these vary markedly from country to country)
- standardise protocols for patient evaluation, risk assessment and data collection
- further and improved education for healthcare administrators and patients on SSIs

To further the last bullet point above, some of the participants commented that improving patient education could be a very important factor in reducing SSIs. Patients should be made aware of steps that they can take to reduce their susceptibility to SSIs; for example by stopping smoking or by managing their weight. "Although these can be difficult for patients," commented Professor John Fairclough, LLandough Hospital, Cardiff, UK, "this could be a way in which all healthcare professionals can offer support and information to patients; educating them that overall the benefits of losing weight or stopping smoking, for example, can ensure their operation runs more smoothly, with less chance of complications such as SSIs".

Clinicians at the meeting also agreed that there are a number of simple new measures that they themselves could implement which could reduce SSIs, including using washable surgical shoes rather than disposable overshoes and ensuring experienced surgeons either supervise or conduct wound closure procedures.

SSIs have a major impact on patients and healthcare settings, in terms of both morbidity and mortality. Notably, patients who develop SSIs are twice as likely to die1. They usually lead to increased hospital stays or re-admissions and more needs for hospital stays within intensive care or high dependency units. Not only do SSIs impact negatively upon the patients' lives but they also add substantially to healthcare costs such as bed occupancy.

It was also noted by the attending clinicians that SSIs can occur days or even weeks after surgery. Therefore it is not just the time spent by the patient while being attended to in hospital that needs to be taken into account; risks would also need to be minimised for the period after the patient leaves the hospital.

The symposium 'New non-pharmaceutical ways to reduce surgical site infections', took place in Reykjavík, Iceland, in June 2007. This meeting brought together an international group of clinicians and researchers from a number of highly specialised fields such as surgery, anaesthesia and orthopaedics, to review current and emerging strategies for the prevention of surgical site infections (SSIs), a common post-operative complication that imposes a high (and largely avoidable) burden of morbidity and mortality. The meeting was sponsored by an educational grant by Kimberly-Clark.

Kimberly-Clark is a leading global health and hygiene company that is home to some of the world's most trusted and recognised brands - including Kleenex®, Andrex®, Huggies®, Pull-Ups®, Kotex® and Poise® - and holds the No. 1 or No. 2 position in more than 80 countries. In addition to its successful consumer brands, Kimberly-Clark is also a leader in products that clean, care and protect people in their work place or while they are away from home. From hotels to hospitals, the washroom to the workplace, Kimberly-Clark offers a range of innovative products that are driven by insights from customers and end-users.

Two new and innovative products which Kimberly-Clark provide to the healthcare professional community are aimed at the prevention of SSIs, the microbial sealant InteguSeal® and the unique Patient Warming System®. As part of the recent symposium in Reykjavik, clinicians spent time discussing the use of both in the prevention of SSIs.

For more information regarding InteguSeal®, please see here.

For more information on the Kimberly-Clark Patient Warming System please see here.

Around the world, medical professionals turn to Kimberly-Clark for a wide portfolio of solutions that improve the health, hygiene and well-being of their patients and staff. As part of their healing mission, caregivers rely on Kimberly-Clark to deliver clinical solutions and educational resources that they can depend on to prevent, diagnose and manage a wide variety of healthcare-associated infections. This over $1 billion global enterprise of Kimberly-Clark Corporation holds the No.1 and No.2 market share positions in several categories, including infection control solutions, surgical solutions and digestive health. For more information please visit http://www.kchealthcare.com.

References

1. Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical-site infections in the 1990's: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999; 20:725-30