Impact of Polyhexanide Care Bundle on Surgical Site Infections in Paediatric and Neonatal Cardiac Surgery: A Propensity Score-Matched Retrospective Cohort Study
Authors/Creators
- 1. Intensive Care Unit, IRCCS Policlinico San Donato, Milan, Italy
- 2. Pharmacy Service, IRCCS Policlinico San Donato, Milan, Italy
- 3. Health Professions Directorate, Bachelor in Nursing Course, ASST Lodi, Lodi, Italy
- 4. Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
- 5. Health Professions Directorate, IRCCS Policlinico San Donato, Milan, Italy
- 6. Hospital Infection Control Committee, IRCCS Policlinico San Donato, Milan, Italy
- 7. Paediatric Care Unit, IRCCS Policlinico San Donato, Milan, Italy
- 8. Paediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Milan, Italy
- 9. Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy
- 10. Clinical Research Service, IRCCS Policlinico San Donato, Milan, Italy
- 11. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
Description
Abstract
The primary aim of this study was to evaluate the impact of the polyhexamethylene biguanide (PHMB) care bundle on the occurrence rates of surgical site infections (SSIs) in paediatric and neonatal cardiac surgery, addressing a critical gap in paediatric-specific infection prevention protocols. A retrospective cohort study included patients under 18 years old who underwent cardiac surgery at IRCCS Policlinico San Donato. Cohort A (n = 117) received the PHMB care bundle from April to December 2023, while Cohort B (n = 801) received conventional care from September 2020 to March 2023. The 1:1 propensity score matching was used to balance covariates between cohorts, resulting in two comparable cohorts (Cohort A = 114 patients and Cohort B = 112). The study found a significant reduction in SSIs among patients receiving the PHMB care bundle compared with those receiving conventional care (1.8% vs. 7.1%, p = 0.048). The comprehensive nature of the PHMB care bundle, including educational programs, preoperative and postoperative antimicrobial treatments, and consistent application of best practices, was instrumental in achieving these outcomes. Implementing antimicrobial care bundles could significantly reduce SSIs in paediatric cardiac surgery. Future research is needed to refine the tested bundle with prospective approaches.
Keywords: cardiac surgery; infection control; paediatric surgery; polyhexanide; surgical site infection.
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