Colorectal surgery surgical site infection prevention practices in British Columbia

Abstract

Surgical site infections (SSI) pose significant morbidity after colorectal surgery. We sought to document current practices in colorectal surgery SSI prevention in British Columbia (BC). Reporting the current provincial landscape on SSI prevention helps to understand the foundation upon which improvements can take place. We surveyed all BC surgeons performing elective colon and rectal resections, and 97 surveys were completed (60% response rate). Eighty-six per cent of respondent hospitals tracked SSI rates. The reported superficial SSI was less than 5% and the anastomotic leak/organ space rate was less than 10%. All respondents gave preoperative prophylactic antibiotics, with 24% continuing antibiotics postoperatively; 62% are using oral antibiotics (OAB) and mechanical bowel preparation (MBP) and 29% use MBP without OAB. Areas for improvement include OAB with MBP and discontinuing prophylactic antibiotics postoperatively, as recommended by the World Health Organization.

Fig. 1

Demographic distribution of survey respondents.

Fig. 2

Survey responses to the question, “Considering resections you personally have done over the past year, what proportion develop superficial wound infections (blue bar) and what proportion develop anastomotic leak/organ space infection (orange bar)?”

Fig. 3

Survey responses to the question, “When thinking about bowel preparation, which of the following do you most often recommend to your patients?” MBP = mechanical bowel preparation; OAB = oral antibiotics.

Fig. 4

Percentage of colorectal cases performed laparoscopically in the past year.