University of California San Francisco

Department of Surgery Medical Student Portal
October 21, 2017

The October 2017 Update of the UCSF Bridges Curriculum highlights a project of UCSF medical students Ammar Joudeh and Carolyn Rennels to reduce surgical site infections by distributing chlorhexidine wipes to patients before elective surgery at Zuckerberg San Francisco General Hospital. The project is part of a Bridges Curriculum Clinical Microsystems Clerkship (CMC). Jennifer Kerns, MD, MS, MPH, assistant professor in obstetrics and gynecology at ZSFG, serves as coach. 

Surgical site infections (SSI) are a major cause of morbidity and mortality associated with surgical procedures. They occur in 2%-5% of patients undergoing inpatient surgery in the US.1 Patients with SSI have a 2-11 times higher risk of death compared with operative patients without an SSI.2 SSIs are associated with 7-11 additional postoperative hospital days and may be responsible for 3.5-10 billion dollars in additional healthcare expenditures annually.  

The use of chlorhexidine (CHG) wipes, distributed in pre-op anesthesia clinic to patients scheduled for elective, incisional procedures from the neck down at ZSFG, appeared to reduce SSI rates for planned C-sections: 

Surgical site infections (SSI) are a major cause of morbidity and mortality associated with surgical procedures. They occur in 2%-5% of patients undergoing inpatient surgery in the US. Patients with SSI have a 2-11 times higher risk of death compared with operative patients without an SSI. SSIs are associated with 7-11 additional postoperative hospital days and may be responsible for 3.5-10 billion dollars in additional healthcare expenditures annually. At ZSFGH, SSI rates for many procedures are above the California statewide average, with an SIR of 0.96. After CHG was made available for planned C-sections at ZSFG, SSI rates decreased. (footnotes omitted, but appear in full poster - see link below)

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