Abstract
Purpose
In resource-limited settings, up to two-thirds of surgical patients develop surgical site infections (SSIs). Our aim was to implement a multimodal protocol including an occlusive dressing and parental engagement to achieve low SSI rates in patients undergoing elective ambulatory pediatric surgery at a tertiary center in Haiti.
Methods
An observational retrospective review of pediatric patients who underwent elective ambulatory procedures from August 2015 to May 2016 following the implementation of a multimodal protocol consisting of: washing and prepping the operative site with chlorhexidine; review of the surgical safety checklist; one dose of cefazolin before incision; after wound closure application of steri strips, gauze, and tegaderm; and with parental engagement maintenance of the dressing until the follow-up visit.
Results
We performed 119 procedures in 99 patients. Mean age was 6.2 years. The most common procedure was inguinal hernia repair (66%); 89% of parents returned to clinic with their children for the follow-up visit, which occurred on average on day 7.6 (range 3–40 days). The SSI rate was 1% (CI 0.00–0.03).
Conclusion
Implementing a multimodal protocol including an occlusive dressing and parental engagement led to a 1% SSI rate in a resource-constrained setting.
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Funding
No grant support was received for this study. Neema Kaseje receives funding from UBS Optimus Foundation.
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“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.” As a retrospective observational study, formal consent was not required.
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Kaseje, N., Pinard, J., Louis, W.F.J. et al. A multi-model intervention including an occlusive dressing and parental engagement to prevent pediatric surgical site infections for elective ambulatory procedures in a resource-constrained setting: an observational retrospective study from a tertiary center in Central Haiti. Pediatr Surg Int 34, 891–895 (2018). https://doi.org/10.1007/s00383-018-4302-9
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DOI: https://doi.org/10.1007/s00383-018-4302-9