Editor's Note Intraoperative hypotension does not appear to be a clinically important predictor of surgical site infections (SSIs), this study finds. Because hypotension compromises local tissue perfusion, researchers from the Cleveland Clinic hypothesized that intraoperative hypotension might promote infection. Among 2,521 patients included in the analysis, there was no adjusted…

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Editor's Note Very low pressure irrigation with saline is an acceptable, low-cost alternative for irrigating open fractures, this study finds. Managing open fractures requires wound irrigation and debridement, but the effectiveness of various pressures and solutions remains controversial. Researchers investigated the effects of castile soap versus normal saline irrigation delivered…

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Editor's Note Surgical unit safety culture was significantly associated with lower colon surgical site infection (SSI) rates in this study led by Martin A. Makary, MD, MPH, professor of surgery, Johns Hopkins University, Baltimore. Dimensions of safety culture that were linked with lower SSI rates, included: teamwork across units organizational…

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Editor's Note Sterilized wrapped instrument trays demonstrated significantly greater protection than sterilized rigid containers against the ingress of airborne bacteria in this study. Of 111 rigid containers tested, 97 failed to maintain barrier performance, allowing bacterial ingress, while 0 of 161 wrapped trays had detectable contamination. Contamination rates of rigid…

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Editor's Note Patients at Veterans Affairs hospitals who developed postoperative Clostridium difficile infections had a five times higher risk of mortality and a twelve times higher risk of morbidity in this study. This analysis of nearly 500,000 surgical procedures found that out of more than 1,800 patients who developed C…

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Editor's Note This study from Johns Hopkins Bayview Medical Center, Baltimore, found a significant relationship between OR door openings and room pressure. The OR door was opened, on average, once every 2.5 minutes of surgery. For 77 of 191 knee and hip arthroplasties, the doors were open long enough for…

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Three new studies on reducing surgical site infections (SSIs) were reported at the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) conference in July. Researchers at three different institutions identified several process changes that, once implemented, brought down SSI rates. Each study used different methodology, but all…

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The anesthesia quality improvement program at Vanderbilt University Medical Center in Nashville can claim a variety of successes, notably less postoperative hypo- and hyper-glycemia and fewer wound infections. When anesthesia providers noticed they weren’t monitoring blood glucose in patients with diabetes as frequently as their own goals specified, they put…

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During the first half of 2015, the Joint Commission’s top “not compliant” survey citations stemmed from Infection Control IC.02.02.01, which relates to reducing the risk of infections associated with medical equipment, devices, and supplies. Surveyors cited critical access hospitals in 60% of the surveys, hospitals in 54%, and office-based surgery…

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Editor's Note Readmission after emergency general surgery procedures is common and varies widely according to patient factors and diagnosis, this study finds. Of more than 177,000 patients analyzed, nearly 6% were readmitted within 30 days. The most common reasons were surgical site infections (16.9%), gastrointestinal complications (11.3%), and pulmonary complications…

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