BACKGROUND: Surgical site infections (SSIs) are associated with substantial patient morbidity and death. It is estimated that 750,000-1 million SSIs occur in the U.S. each year, utilizing 3.7 million extra hospital days and costing more than $1.6 billion in excess hospital charges. METHOD: Review of pertinent English-language literature. RESULTS: The Surgical Care Improvement Project (SCIP) was embraced as a "one-size-fits-all" strategy to reduce postoperative infectious morbidity 25% by 2010. Unfortunately, the evidence suggests that SCIP by itself has had little efficacy in reducing the overall risk of SSI. Whereas the SCIP initiative represents a first national effort to focus on reducing postoperative infectious morbidity and deaths, it fails to consider salient risk factors such as body mass index and selected surgical practices, including tourniquet application prior to incision. CONCLUSION: Rather than focus on a single risk-reduction strategy, future efforts to improve surgical outcomes should embrace a "SCIP-plus" multi-faceted, tiered interventional strategy that includes pre-admission antiseptic showering, state-of-the-art skin antisepsis, innovative antimicrobial technology, active staphylococcal surveillance, and pharmacologic-physiologic considerations unique to selective patient populations.
BACKGROUND: Surgical site infections (SSIs) are associated with substantial patient morbidity and death. It is estimated that 750,000-1 million SSIs occur in the U.S. each year, utilizing 3.7 million extra hospital days and costing more than $1.6 billion in excess hospital charges. METHOD: Review of pertinent English-language literature. RESULTS: The Surgical Care Improvement Project (SCIP) was embraced as a "one-size-fits-all" strategy to reduce postoperative infectious morbidity 25% by 2010. Unfortunately, the evidence suggests that SCIP by itself has had little efficacy in reducing the overall risk of SSI. Whereas the SCIP initiative represents a first national effort to focus on reducing postoperative infectious morbidity and deaths, it fails to consider salient risk factors such as body mass index and selected surgical practices, including tourniquet application prior to incision. CONCLUSION: Rather than focus on a single risk-reduction strategy, future efforts to improve surgical outcomes should embrace a "SCIP-plus" multi-faceted, tiered interventional strategy that includes pre-admission antiseptic showering, state-of-the-art skin antisepsis, innovative antimicrobial technology, active staphylococcal surveillance, and pharmacologic-physiologic considerations unique to selective patient populations.
Authors: John R Romanelli; Pascal R Fuchshuber; Jonah James Stulberg; Rebecca Brewer Kowalski; Prashant Sinha; Thomas A Aloia; Rocco Orlando Journal: Surg Endosc Date: 2019-06-03 Impact factor: 4.584
Authors: Justin T Brady; Bona Ko; Samuel F Hohmann; Benjamin P Crawshaw; Jennifer A Leinicke; Scott R Steele; Knut M Augestad; Conor P Delaney Journal: Surg Endosc Date: 2017-12-27 Impact factor: 4.584
Authors: Erika D Sears; Adeyiza O Momoh; Kevin C Chung; Yu-Ting Lu; Lin Zhong; Jennifer F Waljee Journal: Plast Reconstr Surg Date: 2017-08 Impact factor: 4.730
Authors: Charles E Edmiston; Candace J Krepel; Richard M Marks; Peter J Rossi; James Sanger; Matthew Goldblatt; Mary Beth Graham; Stephen Rothenburger; John Collier; Gary R Seabrook Journal: J Clin Microbiol Date: 2012-11-21 Impact factor: 5.948
Authors: Robert Garcia; Sue Barnes; Roy Boukidjian; Linda Kaye Goss; Maureen Spencer; Edward J Septimus; Marc-Oliver Wright; Shannon Munro; Sara M Reese; Mohamad G Fakih; Charles E Edmiston; Martin Levesque Journal: Am J Infect Control Date: 2022-05-04 Impact factor: 4.303