HARVEST LIMB INFECTIONS; THE SECRET SURGICAL NIGHTMARE AND HOW TO PREVENT THEM

Abstract

Cardiac Surgery is a growing reality within an aging population. One of the major contributors to postoperative morbidly is Surgical Site Infections (SSI). The costs are significant, both monetary and in loss of quality of life; it is estimated that one SSI event can cost approximately $30,000. At Vancouver General Hospital (VGH) Cardiac Surgery, our goal was to reduce our SSI rates from 8% to 2% by January 30, 2014. The multidisciplinary team designed a strategy to reduce the SSI rate using best practices. VGH has a number of established practices to reduce infection. The new processes introduced included tightened antibiotic timing and re-dosing, new dressing products and protocols for the surgical and harvest site. Based on the American College of Surgeons National Surgical Quality Improvement Program database (ASC NSQIP) our SSI rate for the last 7 months is 1.0%. The new dressing for harvest limb incisions has an estimated added cost of $25,000 per year. Over 6 months, a possible cost avoidance of $ 180,000 was achieved based on previous surveillance data. The front line staff is an essential part of realizing these results. This presentation focuses on the addition of new dressing protocols for the post operative harvest limb site. Patient surveillance was followed for 90 days of the post operative period. This has shown a decrease in post operative swelling and drainage in the harvest limb, decrease in home care referrals, readmissions, and antibiotic use in the post hospital environment along with improved patient satisfaction.