The Surgical Care Improvement Project (SCIP) requires that patients receive prophylactic antibiotics within 1 hour prior to incision, but research recently published online by JAMA Surgery suggests that timing isn't everything.
A team of researchers led by Mary T. Hawn, MD, MPH, of the University of Alabama at Birmingham — who has previously questioned how effective SCIP measures are in preventing infections — examined data from 112 Veterans Affairs hospitals nationwide pertaining to this quality reporting metric.
Out of 32,459 procedures between 2005 and 2009, including hip and knee arthroplasties, colorectal surgeries, hysterectomies and arterial vascular cases, 1,497 (4.6%) resulted in surgical site infections. The study's authors found that the orthopedic surgery patients tended to suffer more SSIs when vancomycin was administered, and that the colorectal patients saw fewer SSIs on cefazolin and quinolone. But they did not see a significant correlation between compliance with the antibiotic timing measure and lower SSI rates.
"The SSI risk varies by patient and procedure factors as well as antibiotic properties but is not significantly associated with prophylactic antibiotic timing," they write. "While adherence to the timely prophylactic antibiotic measure is not bad care, there is little evidence to suggest that it is better care."
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