Lehigh Valley Health Network

Allentown, Pennsylvania

Citation

Wojcik A. Fighting the down and dirty of colon rectal SSIs. Poster presented at: The Association of periOperative Registered Nurses (AORN) Surgical Conference & Expo 2014; March 28-April 2, 2014; Chicago, IL.

SSI Prevention Bundle for Colorectal Surgery

Pre-Hospital
Preadmission Chlorhexadine Gluconate shower Preoperative CHG wipes
Preoperative
No hair removal/immediate hair clipping Adherence to weight-based antibiotic administration, to include Gentamicin Standardize skin prep
Preparation of “clean” mayo stand for closure
Intraoperative
Separation of “dirty” and “clean” instruments Routine adherence to “wound protection” for all cases Glove change and sterile sleeve application after intra-operative digital rectal exam or draping
Specimen considered dirty and isolated in basin prior to handoff Extra suction, cautery tip, and light handle covers changed after an anastomosis Glove and instrument change for fascial closure
Saline irrigation of fascia and subQ prior to closure Use of clean Mayo instrumentation for closing Standard application of wound dressing
Continuation of OR wound dressing for 48 hours Reframe incision site with clean towels or sticky drapes after bowel reanastomosis Irrigate subcutaneous tissue with saline prior to closure
During stoma creation, cover the incision site with a clear adhesive drape