Donald E Fry

..The evolution of strategies for the prevention of SSI has had the correct use of preventive antibiotics as a crucial component...

..Surgical site infection (SSI) continues to be a common if often times preventable infection. Considerable patient morbidity and economic cost are the consequences...

....

..The identification of cost-effective hospitals permits objective measurement of excessive surgical costs and development of strategies to improve outcomes and efficiency...

..Control charts have been proposed for the measurement of quality in surgical care...

..Uncomplicated surgical care has highly variable costs. High costs of complications have led payers to deny additional payments even for predictable complications...

..Risk-adjusted outcomes of surgical care are important for quality and cost assessments. Although cardiac surgery is commonly studied, risk-adjusted analysis of excess costs of lung resection has not been pursued...

..Risk-adjustment equations used in these analyses must contain sufficient clinical detail to ensure accurate measurements of hospital quality...

..Wide ranges of reported hospital death rates led us to hypothesize that survival after elective colon resection would be a legitimate outcomes measure for quality of surgical practice...

..We propose that excess risk-adjusted, postoperative length of stay (poLOS) is a valid indicator of an adverse outcome...

....

..Elective peripheral vascular surgery provides quality outcomes that are of great benefit to patients, but have complications that result in severe morbidity and excessive costs...

..Colon preparation for elective colon resection to reduce surgical site infection (SSI) remains controversial...

..An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs...

..To determine whether the occurrence of "never events" after major surgical procedures is affected by patient and disease characteristics and by the type of operation performed...

..In the past, this concern attracted great attention, but recently, this subject has been given much less attention...

..It is likely that other infectious agents will emerge as operating room threats. Surgeons must maintain vigilance in avoiding blood exposure and percutaneous injury...

....

..Surgical infections of interest caused by this pathogen include community-acquired infections, especially of skin and soft tissue; surgical site infections; and nosocomial infections during the post-operative period...

..Concerns persist that double-gloving can compromise the dexterity and tactile sensitivity of the surgeon...

....

..A fundamental reorganization will be required if care is to be broadened and sensible economies achieved...

..We need to adopt a culture dedicated to quality control through better information technology and data-driven initiatives to achieve improved clinical outcomes from infectious complications in surgery...

..Perioperative nurses play an important role as the patient's infection control advocate...

..The actual risk and frequency of operating room transmission remains poorly understood by many surgeons...

..It is concluded that failure to define novel and effective treatments reflects fundamental gaps in our understanding of inflammation and its regulation...

....

..This review was undertaken to bring into focus the relevant literature regarding the costs associated with SSI...

..This reality makes it necessary for civilian disaster-planning strategies to incorporate an understanding of chemical agents, their effects, and the necessary treatment...

..The hypotheses of the study were that concurrent antimicrobial administration affects blood culture yield, prophylactic administration alters the culture result, and repetitive culturing is unnecessary...