title: AMBU-KISS: quality control in ambulatory surgery.
abstract: BACKGROUND
  Cost-containment measures have led to a constant increase in the number of patients cared for as outpatients. Several studies have demonstrated that surgical site infections result in considerable morbidity and excess health care costs from extended duration of hospitalization and antibiotic use.
  
  
  OBJECTIVE
  AMBU-KISS is a protocol designed to create a reference database on surgical site infections for institutions involved in ambulatory surgery.
  
  
  METHODS
  This study was carried out using a physician questionnaire. We compared surgical site infection rates for 3 indicator procedures in the ambulatory setting to those observed in the inpatient setting. The 3 indicator procedures chosen for the protocol were arthroscopic knee surgery and inguinal hernia and vein-stripping procedures.
  
  
  RESULTS
  The arithmetic mean values of surgical site infection rates in arthroscopic surgery of the knee are 0.09% in the ambulatory setting and 0.11% in the hospital setting. For inguinal hernias, the respective rates are 0.65% and 0.78%. These differences, however, did not reach statistical significance (arthroscopic surgery, P = .8323 and inguinal herniotomies, P = .4895). A marked difference was observed for vein-stripping procedures, with surgical site infection rates of 0.38% in the ambulatory setting and 0.64% in the hospital setting. However, this difference was also not statistically significant, P = .1556.
  
  
  CONCLUSIONS
  The AMBU-KISS protocol appears to be suitable for assessing and defining the magnitude of surgical site infections in ambulatory surgery. The preliminary results of our study show no significant differences for the 3 indicator procedures.
authors.affiliation: Institute of Environmental Medicine and Hospital Epidemiology, Freiburg, Germany. mlangeni@iuk3.ukl.uni-freiburg.de
authors.forename: Dennis
authors.initials: D
authors.lastname: Mlangeni
authors.forename: Regina
authors.initials: R
authors.lastname: Babikir
authors.forename: Markus
authors.initials: M
authors.lastname: Dettenkofer
authors.forename: Franz
authors.initials: F
authors.lastname: Daschner
authors.forename: Petra
authors.initials: P
authors.lastname: Gastmeier
authors.forename: Henning
authors.initials: H
authors.lastname: Rüden
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data; D001182:Arthroscopy / Q000706:statistics & numerical data; D003625:Data Collection; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D011159:Population Surveillance / Q000379:methods*; D011786:Quality Control; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014648:Varicose Veins / Q000601:surgery