EP352 - Effect Of Clean Closing Trays In Enhanced Recovery After Surgery Protocol On Surgical Site Infection Rates In Colorectal Surgeries

Sunday, May 11, 2025

8:27 AM – 8:32 AM PT

Location: Monitor 9, Sails Pavilion, Upper Level

ePoster Presenter(s)

Elizabeth Carlson (she/her/hers)

Medical Student
Oakland University William Beaumont School of Medicine
FARMINGTON HILLS, MI, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

SB

Shelli Bergeron, MBA BSN RN

Colorectal Surgical Nurse Coordinator, Enhanced Recovery after Surgery
Corewell Health William Beaumont University Hospital
Troy, Michigan, United States

Disclosure information not submitted.
Scarlett B. Hao, MD (she/her/hers)

Fellow
Corewell Health Beaumont
East Carolina University Brody School of Medicine
Royal Oak, MI, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
KL

Kristin LeMarbe, MD

Surgical Resident
Corewell Health William Beaumont University Hospital
Royal Oak, Michigan, United States

Disclosure information not submitted.
NL

Nora Laban, n/a

Medical Student
OUWB
Oak Brook, Illinois, United States

Disclosure information not submitted.
DL

Diana Lee, n/a

Student
OUWB
Royal Oak, Michigan, United States

Disclosure information not submitted.
BK

Bradley Krasnick, MD

Colon and Rectal Surgeon
Corewell Health William Beaumont University Hospital
Royal Oak, Michigan, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

HW

Harry Wasvary, MD

Chief department colon and rectal surgery
Corewell health William Beaumont university hospital
Royal oak, Michigan, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Elizabeth Carlson: This individual has no financial relationships with ineligible companies.

Scarlett B. Hao, MD: This individual has no financial relationships with ineligible companies.

Bradley Krasnick, MD: This individual has no financial relationships with ineligible companies.

Harry Wasvary, MD: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Reducing surgical site infections (SSIs) after colorectal surgeries remains a key quality improvement target. The summative effect of multiple pre-, intra-, and post-operative interventions bundled as part of Enhanced Recovery After Surgery (ERAS) programs have been shown to effectively reduce SSIs, however the individual impact of each intervention has not been well-studied. This study evaluates the impact of clean closing tray use on the rate of SSIs in colorectal surgeries.

Methods/Interventions: A retrospective cohort study was conducted at a single tertiary care center of all colorectal surgeries performed between 2016 and 2021. Patients who had documented infection present at the time of surgery were excluded (PATOS). Primary outcome was rate of SSI in the setting of ERAS and the use of clean closing tray. SSIs were defined by National Healthcare Safety Network (NHSN) criteria. Multivariate logistic regression was performed for adjusted analysis for odds of SSI.

Results/Outcomes: A total of 3,451 surgical cases were included. 50.7% patients (n=1748) participated in ERAS and 32.0% of this group (n=563) had use of clean closing tray. Of the patients not in ERAS (n=1703), 16.9% (n=288) did also use a clean closing tray. The overall rate of SSI was 5.3% of patients not on ERAS and 3.9% of patients on ERAS. Within ERAS, the SSI rate with use of a closing tray was 1.2% (n=7) versus 5.1% without use of a closing tray (n=61). Adjusted odds by regression analysis of SSI with use of clean closing tray was 0.68 (p=0.08) but adjusted odds for deep SSI with use of clean closing tray was 0.36 (p < 0.05) (Figure 1).

Conclusion/Discussion: For patients undergoing colorectal procedures, the use of a clean closing tray reduces the rate of SSI regardless of ERAS protocol, with significant benefit in reducing deep SSI. Reduction in deep SSI is critical to both patient care and hospital reimbursement, supporting the incorporation of a clean closing tray into ERAS protocols for colorectal procedures.