Implementation of Surgical Site Infection Prevention Bundle in Gynaecological Surgeries: A Quality Control Initiative

Background: Surgical site infection (SSI) is the most common post operative morbidity after gynaecological surgeries. There can be multiple risk associated that may or may not be modifiable. Therefore, perioperative bundled approach are designed to reduce surgical site infections. Aim/Objective: To determine whether surgical site infection (SSI) prevention bundle reduces the risk of SSI by 30 days postoperatively compared with the standard hospital protocol. Methods: A randomized control trial was conducted on women who underwent elective gynaecologic surgery from January 2019 to May 2020. The subjects were divided into intervention and control group. The primary outcome was the rate of SSI by 30 days postoperatively. Results: Total 192 women were randomized. the intervention group included 94 and 98 were assigned to the control group. The SSI rate at 30 days after surgery was 8 /85 (9.5%) in intervention group and 22/85 (25.8%) in control group (p value=0.005; RR=0.36;95% confidence interval [CI], 0.17-0.77). The relative risk reduction of SSI was 64% (p value=0.005) after the bundle was implemented. In subgroup analysis, the primary outcomes were affected by the subgroups like age, co morbidities and operative characteristics. Conclusion: SSI prevention bundle intervention led to significant decrease in overall SSI rate in electively planned gynecological surgeries.