NYU Langone Hospital

Brooklyn, New York

Citation

Parizh D, Ascher E, Raza Rizvi SA, Hingorani A, Amaturo M, Johnson E. Quality improvement initiative: Preventative Surgical Site Infection Protocol in Vascular Surgery. Vascular. 2017;26(1):47-53.

Results: Open and endovascular elective surgery

Pre-Bundle Post-Bundle
SSI Rate: 6.8% SSI Rate: 1.6%

SSI Prevention Bundle for Vascular Surgery – Open Lower Extremity Revascularization Procedures

Inpatient
Skin Prep

2% CHG baths Daily

Day of Surgery
Hair Removal

Hair clipping outside of OR

Skin Prep

4% CHG wipes to groin and skin

Skin Assessment

Skin assessment of surgical site by attending surgeon

Intraoperative

Avoid cauterization of the skin edges

Do not create multiple tissue planes

Minimize undo retraction on skin

Identify and ligate small and large lymphatic channels

Perform meticulous hemostasis

Ensure perfect apposition of skin edges (closure to be done by vascular fellow or attending)
After skin closure, apply skin glue; Let dry prior to dressing placement
Postoperative
Dressing

Keep dressing on for 48 hrs (as long as sterile and dry to avoid contamination)