Changing the Surgical Team for Wound Closure and Surgical Site Infection

Study Overview
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Brief Summary
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Surgical site infection is a frequent complication after abdominal surgery. The wound closure is done at the end of the procedure when the attention of the entire team may be affected because of tiredness and reduced attention of the surgical team. With this study, the investigators aim to test if an exchange of the surgical team by a specialised wound closure team may reduce the impact of surgical site infection.

Official Title
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Impact of Changing the Surgical Team for Wound Closure on Surgical Site Infection: a Matched Case-control Study

Conditions
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Incidence of Surgical Site Infection, Morality, Fascial Hernia

Intervention / Treatment
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* Procedure: Changing the surgical team for wound closure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: General Consent as documented by signature Patients undergoing elective or emergency abdominal surgery from Monday to Friday with wound closure from 8:00 until 17:30 and duration of operation. Age over 18 years Exclusion Criteria: Patients < 18 years of age Patients with preexisting SSI

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Intervention Group<br>The intervention consisted in the closure of the abdominal wall and skin by a second surgical team which included a board-certified surgeon and a resident. | Procedure: Changing the surgical team for wound closure<br>* The intervention consists of the exchange of the primary surgical team with a second surgical team that consists of one surgeon and one student. The first surgical team then may leave the operation theatre but is continuously accessible for questions.<br>|
| Baseline Group<br>During the baseline period, closure of the abdominal wall was performed by the main surgical team, the same team that performed the whole surgery. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with SSIs | SSI that occur after surgery will be assessed according to the criteria developed by the Centers for Disease Control and Prevention. Infections will be categorized as incisional (superficial or deep) infections or organ-space infections. Superficial SSI (type 1) involve only skin and subcutaneous tissue and exclude stitch abscesses. Deep SSI (type 2) involve deeper soft tissues, like fascia and muscle, at the site of incision. Organ-space SSI (type 3) involve any organ or body cavity | 30 days postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | Postoperative Mortality at 30 days | 30 days postoperative | 
| Numbers of patients with fascial dehiscence at 30 days postoperative |  | 30 days postoperative | 
| Numbers of patients with complications | Assessment according to Clavien-Dindo grading | 30 days postoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Surgical Site Infection, Changing the surgical team