Preventing surgical site infection using operating room bundle of care in patients undergoing elective exploratory laparotomy cholecystectomy surgery
Article Category: Original Article
Published Online: Sep 21, 2023
Page range: 335 - 345
Received: Jul 21, 2022
Accepted: Dec 15, 2022
DOI: https://doi.org/10.2478/fon-2023-0037
Keywords
© 2023 Erika Leslie R Magat et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Objective
Surgical procedures manifest immense risks to patients. One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical site infection (SSI). Although several efforts are being undertaken to determine the proper means to reduce such complications, there is still a high incidence of SSI worldwide. Surgery requires knowledge in infection control and high precision in maintaining a clean surgical site. This study tested the effectiveness of an operating room (OR) bundle of care in preventing SSI in patients undergoing elective exploratory laparotomy cholecystectomy surgery.
Methods
A quasi-experimental pretest and posttest design was utilized to determine its effectiveness. The study was composed of 60 participants divided into two groups: 30 subjects were selected to receive the OR bundle of care, while the other 30 subjects received the usual care. The groupings were determined through a systematic random sampling technique. The OR bundle of care had three interventions, namely: (1) maintaining perioperative normothermia, (2) no pre-operative surgical site hair removal, and (3) changing gloves before abdominal wall closure. These patients were evaluated using the standard instrument, Bates–Jensen Wound Assessment Tool (BWAT) in the post-intervention phases of the wound healing process, which are as follows: hemostasis, inflammatory, and proliferative phases. To describe the difference in the patients’ wound status after implementation of the OR bundle of care in each post-intervention phase, Friedman’s test was used. To describe the difference in the patients’ wound status in both groups after implementation of the OR bundle of care, the Mann–Whitney U test was used.
Results
The patient’s wound status was lower, indicating a more healing process. Differences between the wound status of the control and the experimental group were observed on the third postoperative day. This indicates that the experimental group’s wound status healed much faster and more effectively than the control group based on the BWAT scoring severity scoring. A significant difference in the patient’s wound status from the hemostasis phase compared with the proliferative phase was observed.
Conclusions
The OR bundle of care has been shown to be effective in preventing SSI in patients who had undergone exploratory laparotomy cholecystectomy surgery in the selected hospital, if there is uniform and consistent implementation of the said intervention.