title: Colorectal surgery and surgical site infection: is a change of attitude necessary?
abstract: BACKGROUND
  Surgical site infection (SSI) can be as high as 30% in patients undergoing colorectal surgery and is associated with an increase in morbidity and mortality. The aim of this study is to evaluate the impact of a set of simple preventive measures that have resulted in a reduction in surgical site infection in colorectal surgery.
  Prospective study with two groups of patients treated in the colorectal unit of the "Clinico Universitario Lozano Blesa" hospital in Zaragoza. One group was subject to our measures from February to May 2015. The control group was given conventional treatment within a time period of 3 months before the set of measures were implemented.
  
  
  RESULTS
  One hundred forty-nine patients underwent a major colorectal surgical procedure. Seventy (47%) belonged to the control group and were compared to the remaining 79 patients (53% of the total), who were subject to our treatment bundle in the period tested. Comparing the two groups revealed that our set of measures led to a general reduction in SSI (31.4 vs. 13.6%, p = 0.010) and in superficial site infection (17.1 vs. 2.5%, p = 0.002). As a consequence, the postoperative hospital stay was shortened (10.0 vs. 8.0 days, p = 0.048). However, it did not, the number of readmissions nor the re-operation rate. SSI was clearly related to open surgery.
  
  
  CONCLUSIONS
  The preventive set of measures applied in colorectal surgery led to a significant reduction of the SSI and of the length of hospital stay.
authors.affiliation: Colorectal Department, University Hospital of Zaragoza, San Juan Bosco Avenue, 15, 50009, Zaragoza, Spain.|Instituto de Investigaciones Sanitarias de Aragon (IIS), Zaragoza, Spain.
authors.forename: Manuela
authors.initials: M
authors.lastname: Elia-Guedea
authors.affiliation: Colorectal Department, University Hospital of Zaragoza, San Juan Bosco Avenue, 15, 50009, Zaragoza, Spain.|Instituto de Investigaciones Sanitarias de Aragon (IIS), Zaragoza, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Cordoba-Diaz de Laspra
authors.affiliation: Colorectal Department, University Hospital of Zaragoza, San Juan Bosco Avenue, 15, 50009, Zaragoza, Spain. esti.egallego@hotmail.com.|Instituto de Investigaciones Sanitarias de Aragon (IIS), Zaragoza, Spain. esti.egallego@hotmail.com.
authors.forename: Estibaliz
authors.initials: E
authors.lastname: Echazarreta-Gallego
authors.affiliation: Colorectal Department, University Hospital of Zaragoza, San Juan Bosco Avenue, 15, 50009, Zaragoza, Spain.
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Valero-Lazaro
authors.affiliation: Colorectal Department, University Hospital of Zaragoza, San Juan Bosco Avenue, 15, 50009, Zaragoza, Spain.|Instituto de Investigaciones Sanitarias de Aragon (IIS), Zaragoza, Spain.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Ramirez-Rodriguez
authors.affiliation: Colorectal Department, University Hospital of Zaragoza, San Juan Bosco Avenue, 15, 50009, Zaragoza, Spain.|Instituto de Investigaciones Sanitarias de Aragon (IIS), Zaragoza, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Aguilella-Diago
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003107:Colorectal Surgery / Q000009:adverse effects*; D003710:Demography; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bundle of measures; Colorectal surgery; Risk factor