Non-Scrubbed Personnel in Cardiac Surgery Have Poor Infection Control Compliance

Surgical site infections (SSIs) are challenging problems leading to significant postoperative morbidity and mortality and may reflect the level of adherence to infection control policies. Researchers from Mater dei Hospital in Msida, Malta used a structured observational method to collect data about infection control practices among surgeons, anesthetists, nurses, cardiopulmonary bypass technicians and orderlies practicing in the cardiac operating room during open-heart surgery. To prevent bias, the researchers report that they did not disclose the actual procedures observed to the surgical team members, who knew, however, that they were being observed for infection control practices. The researchers measured the 30-day SSI rate by post-discharge telephonic surveillance among surviving open-heart surgery patients who had consented to the survey.

Tartari, et al. observed infection control practices during 30 randomly chosen operations and found higher level of inadequate practices related to environmental disinfection, hand hygiene, operating room traffic and surgical attire of non-scrubbed personnel (anaesthesiologists and cardiopulmonary bypass technicians).

One-hundred-forty of 155 patients who underwent open-heart surgery were followed up, achieving a response rate of 91.5 percent. Superficial and deep surgical site infections rates were 16.4 percent and 4.3 percent respectively, including both sternal and harvest-site infections.

Tartari, et al. report that they found poor compliance with infection control practices of non-scrubbed personnel involved in cardiac surgery and observed a high surgical site infection rate, the majority being leg wound infections following saphenous vein harvesting. Their research was presented at the International Conference on Prevention & Infection Control (ICPIC) held in Geneva, Switzerland, June 29-July 2, 2011.

Reference: E Tartari, J Mamo and M Borg. Pre-educational intervention survey of healthcare practioners compliance with infection prevention measures in cardiothoracic surgery: low compliance but internationally comparable surgical site infection rate. Presentation at International Conference on Prevention & Infection Control (ICPIC). BMC Proceedings 2011, 5(Suppl 6):O59doi:10.1186/1753-6561-5-S6-O59