Frontofacial Surgery: Reducing Infection with the Development and 6-Year Outcome of a Frontofacial Protocol
Frontofacial surgery (FFS) creates a communication between the cranial and nasal cavities and is associated with significant infection risk. After a cluster of infections affecting patients undergoing FFS, a root cause analysis of index cases was undertaken, but no specifically remedial causes were...
Uložené v:
| Vydané v: | Plastic and reconstructive surgery (1963) Ročník 152; číslo 4; s. 833 |
|---|---|
| Hlavní autori: | , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
| Vydavateľské údaje: |
United States
01.10.2023
|
| Predmet: | |
| ISSN: | 1529-4242, 1529-4242 |
| On-line prístup: | Zistit podrobnosti o prístupe |
| Tagy: |
Pridať tag
Žiadne tagy, Buďte prvý, kto otaguje tento záznam!
|
| Abstract | Frontofacial surgery (FFS) creates a communication between the cranial and nasal cavities and is associated with significant infection risk. After a cluster of infections affecting patients undergoing FFS, a root cause analysis of index cases was undertaken, but no specifically remedial causes were identified. Basic principles incorporating known risk factors for the prevention of surgical-site infection were then applied to the creation of a perioperative management protocol. This study analyzes infection rates before and after its implementation.
The protocol was designed around the needs of patients undergoing FFS and consists of three checklists covering their preoperative, intraoperative, and postoperative care. Compliance required the completion of each checklist. All patients undergoing FFS between 1999 and 2019 were studied retrospectively, and infections occurring before and after the implementation of the protocol were analyzed.
One hundred three patients underwent FFS (60 monobloc and 36 facial bipartition) before the implementation of the protocol in August of 2013, and 30 patients underwent FFS after its implementation. Compliance with the protocol was 95%. After implementation, there was a statistically significant reduction in infections from 41.7% to 13.3% ( P = 0.005).
Although no specific cause for a cluster of postoperative infection had been identified, the implementation of a bespoke protocol consisting of preoperative, perioperative, and postoperative checklists covering measures known to reduce infection risk was associated with a significant reduction in postoperative infections in patients undergoing FFS.
Therapeutic, III. |
|---|---|
| AbstractList | Frontofacial surgery (FFS) creates a communication between the cranial and nasal cavities and is associated with significant infection risk. After a cluster of infections affecting patients undergoing FFS, a root cause analysis of index cases was undertaken, but no specifically remedial causes were identified. Basic principles incorporating known risk factors for the prevention of surgical-site infection were then applied to the creation of a perioperative management protocol. This study analyzes infection rates before and after its implementation.BACKGROUNDFrontofacial surgery (FFS) creates a communication between the cranial and nasal cavities and is associated with significant infection risk. After a cluster of infections affecting patients undergoing FFS, a root cause analysis of index cases was undertaken, but no specifically remedial causes were identified. Basic principles incorporating known risk factors for the prevention of surgical-site infection were then applied to the creation of a perioperative management protocol. This study analyzes infection rates before and after its implementation.The protocol was designed around the needs of patients undergoing FFS and consists of three checklists covering their preoperative, intraoperative, and postoperative care. Compliance required the completion of each checklist. All patients undergoing FFS between 1999 and 2019 were studied retrospectively, and infections occurring before and after the implementation of the protocol were analyzed.METHODSThe protocol was designed around the needs of patients undergoing FFS and consists of three checklists covering their preoperative, intraoperative, and postoperative care. Compliance required the completion of each checklist. All patients undergoing FFS between 1999 and 2019 were studied retrospectively, and infections occurring before and after the implementation of the protocol were analyzed.One hundred three patients underwent FFS (60 monobloc and 36 facial bipartition) before the implementation of the protocol in August of 2013, and 30 patients underwent FFS after its implementation. Compliance with the protocol was 95%. After implementation, there was a statistically significant reduction in infections from 41.7% to 13.3% ( P = 0.005).RESULTSOne hundred three patients underwent FFS (60 monobloc and 36 facial bipartition) before the implementation of the protocol in August of 2013, and 30 patients underwent FFS after its implementation. Compliance with the protocol was 95%. After implementation, there was a statistically significant reduction in infections from 41.7% to 13.3% ( P = 0.005).Although no specific cause for a cluster of postoperative infection had been identified, the implementation of a bespoke protocol consisting of preoperative, perioperative, and postoperative checklists covering measures known to reduce infection risk was associated with a significant reduction in postoperative infections in patients undergoing FFS.CONCLUSIONSAlthough no specific cause for a cluster of postoperative infection had been identified, the implementation of a bespoke protocol consisting of preoperative, perioperative, and postoperative checklists covering measures known to reduce infection risk was associated with a significant reduction in postoperative infections in patients undergoing FFS.Therapeutic, III.CLINICAL QUESTION/LEVEL OF EVIDENCETherapeutic, III. Frontofacial surgery (FFS) creates a communication between the cranial and nasal cavities and is associated with significant infection risk. After a cluster of infections affecting patients undergoing FFS, a root cause analysis of index cases was undertaken, but no specifically remedial causes were identified. Basic principles incorporating known risk factors for the prevention of surgical-site infection were then applied to the creation of a perioperative management protocol. This study analyzes infection rates before and after its implementation. The protocol was designed around the needs of patients undergoing FFS and consists of three checklists covering their preoperative, intraoperative, and postoperative care. Compliance required the completion of each checklist. All patients undergoing FFS between 1999 and 2019 were studied retrospectively, and infections occurring before and after the implementation of the protocol were analyzed. One hundred three patients underwent FFS (60 monobloc and 36 facial bipartition) before the implementation of the protocol in August of 2013, and 30 patients underwent FFS after its implementation. Compliance with the protocol was 95%. After implementation, there was a statistically significant reduction in infections from 41.7% to 13.3% ( P = 0.005). Although no specific cause for a cluster of postoperative infection had been identified, the implementation of a bespoke protocol consisting of preoperative, perioperative, and postoperative checklists covering measures known to reduce infection risk was associated with a significant reduction in postoperative infections in patients undergoing FFS. Therapeutic, III. |
| Author | Hayward, Richard James, Greg van de Lande, Lara S Jeelani, N Owase O'Hara, Justine White, Andrea Dunaway, David J Hartley, John |
| Author_xml | – sequence: 1 givenname: Andrea surname: White fullname: White, Andrea organization: From the Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust – sequence: 2 givenname: Lara S surname: van de Lande fullname: van de Lande, Lara S organization: University College London, Great Ormond Street Institute of Child Health – sequence: 3 givenname: Justine surname: O'Hara fullname: O'Hara, Justine organization: From the Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust – sequence: 4 givenname: John surname: Hartley fullname: Hartley, John organization: From the Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust – sequence: 5 givenname: Richard surname: Hayward fullname: Hayward, Richard organization: From the Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust – sequence: 6 givenname: Greg surname: James fullname: James, Greg organization: From the Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust – sequence: 7 givenname: N Owase surname: Jeelani fullname: Jeelani, N Owase organization: From the Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust – sequence: 8 givenname: David J surname: Dunaway fullname: Dunaway, David J organization: University College London, Great Ormond Street Institute of Child Health |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36940153$$D View this record in MEDLINE/PubMed |
| BookMark | eNpVkD1PwzAYhC1URD_gHyDkkSXFX3ESNlQoVKrUqoWBKXKd120gsYvjgPrvKaIIuOVueHTSXR91rLOA0DklQ0qy5Gq-WA7JrygRgh2hHo1ZFgkmWOdP7qJ-07zsoYTL-AR1ucwEoTHvodexdzY4o3SpKrxs_Rr87hovoGh1add4Yg3oUDqLP8qwwWED-BbeoXLbGmzAyhZYRs-gPJ61QbsasDNY4X-tc--C0646RcdGVQ2cHXyAnsZ3j6OHaDq7n4xuppHmsWSRZrFOAIyMjTZCgSGSGSEkZJTFMi3oisVcgVY0EykjxhRcc6aY4Tpd7QeyAbr87t1699ZCE_K6bDRUlbLg2iZnSZqmZP_XF3pxQNtVDUW-9WWt_C7_OYh9Ap-AaxM |
| CitedBy_id | crossref_primary_10_1177_27325016241300175 |
| ContentType | Journal Article |
| Copyright | Copyright © 2023 by the American Society of Plastic Surgeons. |
| Copyright_xml | – notice: Copyright © 2023 by the American Society of Plastic Surgeons. |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1097/PRS.0000000000010442 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic MEDLINE |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1529-4242 |
| ExternalDocumentID | 36940153 |
| Genre | Journal Article |
| GroupedDBID | --- .-D .XZ .Z2 01R 0R~ 123 1J1 354 40H 4Q1 4Q2 4Q3 53G 5RE 5VS 71W 77Y 7O~ AAAAV AAAXR AAGIX AAHPQ AAIQE AAMOA AAMTA AAQKA AARTV AASCR AASOK AASXQ AAUEB AAXQO ABASU ABBUW ABDIG ABJNI ABOCM ABPXF ABVCZ ABXVJ ABZAD ABZZY ACDDN ACDOF ACEWG ACGFO ACGFS ACILI ACLDA ACNWC ACOAL ACWDW ACWRI ACXJB ACXNZ ACZKN ADGGA ADHPY AE6 AENEX AFBFQ AFDTB AFMBP AFSOK AFUWQ AGINI AHOMT AHQNM AHVBC AIJEX AINUH AJCLO AJIOK AJNWD AJZMW AKCTQ AKULP ALKUP ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW AOQMC BOYCO BQLVK BYPQX C45 CGR CS3 CUY CVF DIWNM DU5 E.X EBS ECM EEVPB EIF ERAAH EX3 F2K F2L F2M F2N F5P FCALG FL- GNXGY GQDEL H0~ HLJTE HZ~ IKREB IKYAY IN~ IPNFZ JF7 JK3 K8S KD2 KMI L-C L7B N9A NPM N~7 N~B O9- OAG OAH OBH OHH OL1 OLB OLG OLH OLU OLV OLY OLZ OPUJH OVD OVDNE OVIDH OVLEI OVOZU OWU OWV OWW OWX OWY OWZ OXXIT P2P RIG RLZ RXW S4R S4S TAF TEORI TSPGW TWZ V2I VVN W3M WH7 WOQ WOW X3V X3W XXN XYM YOC ZFV ZY1 7X8 ADKSD ADSXY |
| ID | FETCH-LOGICAL-c3562-c25c7eef65fcf4aef062f446e912568d1b253aeca194820ffd3c32a2f3c8b7362 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 3 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=001076988500048&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1529-4242 |
| IngestDate | Wed Oct 01 14:50:17 EDT 2025 Mon Jul 21 05:57:09 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 4 |
| Language | English |
| License | Copyright © 2023 by the American Society of Plastic Surgeons. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c3562-c25c7eef65fcf4aef062f446e912568d1b253aeca194820ffd3c32a2f3c8b7362 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| PMID | 36940153 |
| PQID | 2788800446 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2788800446 pubmed_primary_36940153 |
| PublicationCentury | 2000 |
| PublicationDate | 2023-10-01 20231001 |
| PublicationDateYYYYMMDD | 2023-10-01 |
| PublicationDate_xml | – month: 10 year: 2023 text: 2023-10-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Plastic and reconstructive surgery (1963) |
| PublicationTitleAlternate | Plast Reconstr Surg |
| PublicationYear | 2023 |
| SSID | ssj0017365 |
| Score | 2.437409 |
| Snippet | Frontofacial surgery (FFS) creates a communication between the cranial and nasal cavities and is associated with significant infection risk. After a cluster of... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 833 |
| SubjectTerms | Face Humans Retrospective Studies Skull Surgical Wound Infection - epidemiology Surgical Wound Infection - etiology Surgical Wound Infection - prevention & control |
| Title | Frontofacial Surgery: Reducing Infection with the Development and 6-Year Outcome of a Frontofacial Protocol |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/36940153 https://www.proquest.com/docview/2788800446 |
| Volume | 152 |
| WOSCitedRecordID | wos001076988500048&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LS8QwEA7qinjx_VhfRPAatpu0SetFRFwU3LXsqqynkqYZEKFd9-Hvd9J2WT0Igj301pJO5_FlZjIfIRcAyojUaCaMZ5kvQ80wLCjWlgZ45gUmKLkOXx5UrxcOh1FcJ9wmdVvl3CeWjjorjMuRt7jbq5Xlx6vRB3OsUa66WlNoLJOGQCjjDFMNF1UEJUoqSQxREfMxFs2PzkWqFfcH1ejC6sJNiSNr_w1klsGms_nfZW6RjRpm0utKL7bJks13yFq3LqTvkvdOObgAtMuY00F1NvqS9t0gVwxm9L7u0cqpS9RSRIn0W3sR1XlGJXtFK6GPsymuzNICqKY_3hqPi2mBerZHnju3Tzd3rOZdYEYgHGKGB0ZZCzIAA7624EkO-EU2QjQkw6yd8kBoa3Q78hFAAGTCCK45CBOmKHO-T1byIreHhEphPcN9QJSTooSVTkVm2lmq0A2AF3hNcj4XY4J67YoVOrfFbJIsBNkkB9W_SEbVAI5EyAi3hYE4-sPTx2TdMcRX_XcnpAFo1faUrJrP6dtkfFYqDN57cfcLSyDKLA |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Frontofacial+Surgery%3A+Reducing+Infection+with+the+Development+and+6-Year+Outcome+of+a+Frontofacial+Protocol&rft.jtitle=Plastic+and+reconstructive+surgery+%281963%29&rft.au=White%2C+Andrea&rft.au=van+de+Lande%2C+Lara+S&rft.au=O%27Hara%2C+Justine&rft.au=Hartley%2C+John&rft.date=2023-10-01&rft.issn=1529-4242&rft.eissn=1529-4242&rft.volume=152&rft.issue=4&rft.spage=833&rft_id=info:doi/10.1097%2FPRS.0000000000010442&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1529-4242&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1529-4242&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1529-4242&client=summon |