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Surgical Site Infection Prevention "Bundle"

Actions We Take to Prevent Surgical Site Infections

BIDMC is committed to reducing surgical site infections and has implemented a core set of specific actions to eliminate preventable surgical site infections. When taken together, these specific actions (called "bundles") typically result in consistently better outcomes than if each these actions were performed individually.

The Surgical Site Infection Prevention "bundle," which is applied to all surgical procedures at BIDMC, includes:

1. Appropriate use of antibiotics just prior to and during surgery. Studies have shown that hospitals can significantly reduce the risk of an infection after surgery by initiating antibiotics immediately prior to surgery and stopping antibiotics within 24 hours after the surgery. Administering antibiotics beyond 24 hours after surgery increases the risk of side effects and can cause bacteria to become resistant to the medication.
2. Limited or minimal hair removal at the surgical site using clippers. Unlike razors, clipping is not traumatic to skin, and in most cases, it is safer.
3. Use of antimicrobial washes prior to surgery by patients. Patients are instructed to use antiseptic washes the night before and the morning of surgery in order to reduce bacteria on the patient's skin. This practice has been shown to be effective in reducing the chance of infection.
4. Use of antiseptic scrub in the Operating Room, immediately prior to surgery. Right before the surgery takes place, the surgeon cleans the skin where the incision will be made with an antiseptic solution. This practice has also been shown to reduce the chance of infection.

Additional bundle measures are applied to certain procedures when there is evidence that these additional practices may further reduce infection risk. Examples of these practices include:

1. Maintenance of tight glucose control for all patients undergoing cardiac surgery procedures
2. Maintenance of normal temperature postoperatively for all patients immediately following certain types of gastrointestinal procedures 

Last updated: April 6, 2011