• Katherine He, Marie Iwaniuk, Michael J Goretsky, Robert A Cina, Jacqueline M Saito, Bruce Hall, Catherine Grant, Mark E Cohen, Jason Newland, Matthew Hall, Clifford Y Ko, and Shawn J Rangel.
• Department of Surgery, Boston Children's Hospital, Boston, MA.
• Ann. Surg. 2023 Aug 1; 278 (2): 280287280-287.

ObjectiveTo establish surgical site infection (SSI) performance benchmarks in pediatric surgery and to develop a prioritization framework for SSI prevention based on procedure-level SSI burden.BackgroundContemporary epidemiology of SSI rates and event burden in elective pediatric surgery remain poorly characterized.MethodsMulticenter analysis using sampled SSI data from 90 hospitals participating in NSQIP-Pediatric and procedural volume data from the Pediatric Health Information System (PHIS) database. Procedure-level incisional and organ space SSI (OSI) rates for 17 elective procedure groups were calculated from NSQIP-Pediatric data and estimates of procedure-level SSI burden were extrapolated using procedural volume data. The relative contribution of each procedure to the cumulative sum of SSI events from all procedures was used as a prioritization framework.ResultsA total of 11,689 nonemergent procedures were included. The highest incisional SSI rates were associated with gastrostomy closure (4.1%), small bowel procedures (4.0%), and gastrostomy (3.7%), while the highest OSI rates were associated with esophageal atresia/tracheoesophageal fistula repair (8.1%), colorectal procedures (1.8%), and small bowel procedures (1.5%). 66.1% of the cumulative incisional SSI burden from all procedures were attributable to 3 procedure groups (gastrostomy: 27.5%, small bowel: 22.9%, colorectal: 15.7%), and 72.8% of all OSI events were similarly attributable to 3 procedure groups (small bowel: 28.5%, colorectal: 26.0%, esophageal atresia/tracheoesophageal fistula repair: 18.4%).ConclusionsA small number of procedures account for a disproportionate burden of SSIs in pediatric surgery. The results of this analysis can be used as a prioritization framework for refocusing SSI prevention efforts where they are needed most.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

21 keywords...

hide…