A multi-model intervention including an occlusive dressing and parental engagement to prevent pediatric surgical site infections for elective ambulatory procedures in a resource-constrained setting: an observational retrospective study from a tertiary center in Central Haiti

Neema Kaseje, Jacquemine Pinard, Willy Fils Jean Louis, Jean Louis MacLee, Andre Patrick Jeudy, Henri Ford

Research output: Contribution to journalArticle

Abstract

Purpose: In resource-limited settings, up to two-thirds of surgical patients develop surgical site infections (SSIs). Our aim was to implement a multimodal protocol including an occlusive dressing and parental engagement to achieve low SSI rates in patients undergoing elective ambulatory pediatric surgery at a tertiary center in Haiti. Methods: An observational retrospective review of pediatric patients who underwent elective ambulatory procedures from August 2015 to May 2016 following the implementation of a multimodal protocol consisting of: washing and prepping the operative site with chlorhexidine; review of the surgical safety checklist; one dose of cefazolin before incision; after wound closure application of steri strips, gauze, and tegaderm; and with parental engagement maintenance of the dressing until the follow-up visit. Results: We performed 119 procedures in 99 patients. Mean age was 6.2 years. The most common procedure was inguinal hernia repair (66%); 89% of parents returned to clinic with their children for the follow-up visit, which occurred on average on day 7.6 (range 3–40 days). The SSI rate was 1% (CI 0.00–0.03). Conclusion: Implementing a multimodal protocol including an occlusive dressing and parental engagement led to a 1% SSI rate in a resource-constrained setting.

Original languageEnglish (US)
Pages (from-to)891-895
Number of pages5
JournalPediatric Surgery International
Volume34
Issue number8
DOIs
StatePublished - Aug 1 2018
Externally publishedYes

Fingerprint

Occlusive Dressings
Haiti
Surgical Wound Infection
Observational Studies
Retrospective Studies
Pediatrics
Cefazolin
Chlorhexidine
Inguinal Hernia
Herniorrhaphy
Bandages
Checklist
Ambulatory Surgical Procedures
Parents
Maintenance
Safety
Wounds and Injuries

Keywords

  • Global surgery
  • Infection
  • Outcomes
  • Patient safety
  • Pediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

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title = "A multi-model intervention including an occlusive dressing and parental engagement to prevent pediatric surgical site infections for elective ambulatory procedures in a resource-constrained setting: an observational retrospective study from a tertiary center in Central Haiti",
abstract = "Purpose: In resource-limited settings, up to two-thirds of surgical patients develop surgical site infections (SSIs). Our aim was to implement a multimodal protocol including an occlusive dressing and parental engagement to achieve low SSI rates in patients undergoing elective ambulatory pediatric surgery at a tertiary center in Haiti. Methods: An observational retrospective review of pediatric patients who underwent elective ambulatory procedures from August 2015 to May 2016 following the implementation of a multimodal protocol consisting of: washing and prepping the operative site with chlorhexidine; review of the surgical safety checklist; one dose of cefazolin before incision; after wound closure application of steri strips, gauze, and tegaderm; and with parental engagement maintenance of the dressing until the follow-up visit. Results: We performed 119 procedures in 99 patients. Mean age was 6.2 years. The most common procedure was inguinal hernia repair (66{\%}); 89{\%} of parents returned to clinic with their children for the follow-up visit, which occurred on average on day 7.6 (range 3–40 days). The SSI rate was 1{\%} (CI 0.00–0.03). Conclusion: Implementing a multimodal protocol including an occlusive dressing and parental engagement led to a 1{\%} SSI rate in a resource-constrained setting.",
keywords = "Global surgery, Infection, Outcomes, Patient safety, Pediatric",
author = "Neema Kaseje and Jacquemine Pinard and Louis, {Willy Fils Jean} and MacLee, {Jean Louis} and Jeudy, {Andre Patrick} and Henri Ford",
year = "2018",
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language = "English (US)",
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AU - Pinard, Jacquemine

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N2 - Purpose: In resource-limited settings, up to two-thirds of surgical patients develop surgical site infections (SSIs). Our aim was to implement a multimodal protocol including an occlusive dressing and parental engagement to achieve low SSI rates in patients undergoing elective ambulatory pediatric surgery at a tertiary center in Haiti. Methods: An observational retrospective review of pediatric patients who underwent elective ambulatory procedures from August 2015 to May 2016 following the implementation of a multimodal protocol consisting of: washing and prepping the operative site with chlorhexidine; review of the surgical safety checklist; one dose of cefazolin before incision; after wound closure application of steri strips, gauze, and tegaderm; and with parental engagement maintenance of the dressing until the follow-up visit. Results: We performed 119 procedures in 99 patients. Mean age was 6.2 years. The most common procedure was inguinal hernia repair (66%); 89% of parents returned to clinic with their children for the follow-up visit, which occurred on average on day 7.6 (range 3–40 days). The SSI rate was 1% (CI 0.00–0.03). Conclusion: Implementing a multimodal protocol including an occlusive dressing and parental engagement led to a 1% SSI rate in a resource-constrained setting.

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