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Surgical Site Infections Persist, But Why?
Therefore, he says, federal policy should not punish hospitals when these infections occur until:
- We know a heck of a lot more about the underlying process by which an infection takes hold in a surgical site.
- We understand which genomic sequences in certain populations make them more susceptible to an infection.
- We spend money to conduct much more basic science research into the epidemiology and risk factors linked to site surgical infections, such as unknown environmental factors in the hospital.
I agree that we need more research on why some people will get surgical site infections under the exact same circumstances that others don't. I know first hand that these infections can hit without any apparent logic, even in a brand new hospital where an otherwise healthy friend was infected late last year.
It will be interesting to see if there are genetic subtypes.
But I don't think the CMS policy to not pay for surgical site infections is wrong-headed. Those now on the list include infections incurred during certain orthopedic procedures, such as mediastinitis following coronary artery bypass graft operations and bariatric procedures.
And I wonder what we would do if we discovered such vulnerable DNA sequences. Would we do more prep work than we do now? Keep these patients in the hospital longer? Not allow them to have surgery?
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Comments are moderated. Please be patient.
Paula Forte (5/31/2012 at 3:51 PM)
Your author asks, if we found vulnerable DNA, "Would we do more prep work than we do now? Keep these patients in the hospital longer? Not allow them to have surgery?" We don't have the DNA test to prove vulnerability to SSIs but we do know when our patients are poor surgical risks. For them we DO delay surgery and work with them and their faimilies in a specialty clinc (sometimes for up to a year) to build protein stores, pulmonary function, etc. in order to enhance their outcomes (and ours) when surgery is performed. We are not to zero yet, but for our population which is already high risk, thanks to incredible vigilance on many clinician's part, we beat the NHSN benchmark most quarters.