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STS 2014: Preventing SSIs in CABG

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The Particulars: Surgical site infections (SSIs) can increase mortality, readmission rates, lengths of stay, and costs when compared with no SSIs. Investigators report that there is a need to reduce the rate of SSIs after isolated CABG with donor site surgery.

Data Breakdown: A study team of cardiothoracic surgeons, nurses, and support personnel analyzed inconsistencies and variations in their processes to determine if these procedures mirrored best practices. Areas for improvement were identified and rapidly acted upon. Changes made included using chlorohexidine oral rinses until discharge, disposable EKG leads, silver impregnated mid-sternal dressings, new sutures, and surgical techniques. All processes were then standardized. From March 2012 to March 2013, the SSI rate dropped to 0.7 per 100 procedures, with no SSIs observed since May 2012.

Take Home Pearl: Identifying where surgical procedures do not mirror best practices and implementing changes to address these shortcomings appears to help eliminate SSIs after isolated CABG with donor site surgery.

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