1364. Analysis of Overlapping Surgery and Surgical Site Infection at a High-Volume Tertiary Care Center

Authors: Jeffrey Paul Mullin, MD; Connor Wathen, MD; Michael Steinmetz; Jorge Gonzalez; Andre Machado (Buffalo, NY)

Introduction: The practice of overlapping surgeries has come under scrutiny recently following the publication of an investigative report in the Boston Globe.2 Highlighting the public interest regarding this topic, an inquiry by the United States Senate was initiated to determine the frequency at which the practice of overlapping surgeries is performed at large teaching hospitals.3 While evidence has begun to accumulate regarding the overall safety of overlapping surgery in the neurosurgical field,4–6 the present study aims to specifically address the influence of overlapping surgery on the risk of surgical site infection (SSI), one of the most common and costly post-operative complications. Methods: Data was collected for all surgical procedures performed within our hospital between January 1, 2009 and December 31, 2015. Data regarding incision open and closure times, the total number of providers in the OR, including each individual’s role, procedure description, and data regarding the type, dose, and time of administration of prophylactic antibiotics were obtained from OR and anesthesia records. All statistical analysis was performed with SAS version 9.4 Results: 12,014 cases were included in the study period, 281 SSI (2.3%) were identified. 27% of cases overlapped with another procedure conducted by the primary surgeon. A multivariable logistic regression was performed, including duration of overlap rather than a binary variable. In this model, patient age, BMI, gender, the number of people in the OR, surgery duration, and the duration of overlap were included. Again, duration of overlap did not demonstrate any effect upon the odds of infection Conclusion: The findings of the current study provide further evidence in support of the safety of overlapping surgery. Although univariable analysis showed a significant increase in infection rates, after controlling for additional variables, there was no significant association between overlapping surgery and surgical site infection