PAPS Best of the Best Winner

Surgical site infections are a costly yet modifiable source of morbidity, particularly within the neonatal population.

Equivalent data does not yet exist for the neonatal surgical population for CHG versus povidone antisepsis.

The neonatal skin antisepsis protocol included lower limits of 34 weeks post-conception age and 1500 grams weight, limited to general surgery patients only.

The protocol used either 2% or 0.5% CHG based on age cutoffs.

Skin integrity was assessed using a validated tool called the neonatal skin condition score.

Implementation of the protocol occurred in February 2020.

A total of 50 patients were included in the protocol, none of which experienced adverse skin prep outcomes.

8% of patients on the CHG protocol developed SSIs within the 30-day post-op period compared to 14% in the matched retrospective povidone cohort.

A comparison of SSI rates between the CHG versus povidone cohort revealed no significant difference.

The majority of cases were class two clean-contaminated cases.

The protocol was largely modeled off the McGill protocol used in Quebec, Canada, which used a lower age cutoff of 28 weeks gestational age with a lower weight cutoff of 1,000 grams.

The project was conducted in conjunction with multiple SSI reduction initiatives including optimizing antibiotic prophylaxis, using adherent draping, and implementing a clean closure bundle for class two clean-contaminated cases.

The clean closure bundle included changing gloves prior to closure.

The decrease in SSI rate from 14% to 8% was not statistically significant.

The protocol was used for all general surgery cases that did not have any open exposed mucosa and in which the patient was not allergic to CHG or IPA.