Document Type
Conference Proceeding
Publication Date
5-15-2025
Abstract
Introduction: Reducing surgical site infections (SSIs) after colorectal surgeries remains a key quality improvement target. The summative effect of multiple pre-, intra-, and postoperative interventions bundled as part of Enhanced Recovery After Surgery (ERAS) programs are shown to effectively reduce SSIs, however the individual impact of each intervention has not been well-studied. This study evaluates the impact of clean closing tray use on the rate of SSIs in colorectal surgeries. Methods: A retrospective cohort study was conducted at a single tertiary care center of all intraabdominal colorectal surgeries performed between 2016 and 2021. Patients with documented infection present at the time of surgery (PATOS) were excluded. The primary outcome was the rate of SSI in the setting of ERAS and with use of clean closing tray. SSIs were defined by National Healthcare Safety Network (NHSN) criteria. Multivariate logistic regression was performed for adjusted analysis for odds of SSI. Results: Of the 3,451 cases included, approximately half (50.7%, n=1,748) participated in ERAS and 32.0% of ERAS cases (n=563) had use of a clean closing tray. Of the 1,703 non-ERAS cases, 16.9% (n=288) had use of a closing tray. The overall rate of SSI was 3.9% in ERAS patients and 5.3% in non-ERAS patients (p=.043). Among ERAS patients, the SSI rate with use of a closing tray was 1.2% (n=7) versus 5.1% (n=61) without use of a closing tray (p=.00008). Adjusted odds by regression analysis of SSI with use of a clean closing tray regardless of ERAS participation was 0.68 (p=0.08) but adjusted odds for deep SSI with use of closing tray was 0.36 (p< .05). Conclusion: For patients undergoing intraabdominal colorectal surgery, the use of a clean closing tray reduces the rate of SSI regardless of ERAS participation, with a significant benefit demonstrated in reducing deep SSIs. Reduction in deep SSIs is important to both patient care and hospital reimbursement. These findings support the incorporation of clean closing trays in ERAS protocols for colorectal surgeries.
Recommended Citation
Carlson E, Laban N, Bergeron S, Lee D, Kayal D, LeMarbe K, et al. [Hao S, Mesiti J, Krasnick B, Wasvary H]. Effect of clean closing tray use on surgical site infections following colorectal surgeries. Presented at: Michigan Chapter of the American College of Surgeons 71st Annual Meeting; 2025 May 15; Belliare, MI. Available from:https://www.michiganacs.org/wp-content/uploads/2025/09/Michigan-Program-Book-2025.pdf
Comments
Michigan Chapter of the American College of Surgeons 71st Annual Meeting, May 14-16, 2025, Bellaire, MI