{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:18:45Z","timestamp":1786979925898,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A reduction in surgical site infections (SSIs) has been reported in several discrete patient populations during the COVID\u201019 pandemic. Herein, this study evaluates the impact of the COVID\u201019 pandemic on SSI in a large patient cohort incorporating multiple surgical disciplines. We hypothesize that enhanced infection control and heightened awareness of such measures is analogous to an SSI care bundle, the hypothetical \u201cCOVID bundle\u201d, and may impact SSI rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Data collected for the American College of Surgeons National Surgical Quality Improvement Program between January 1, 2015, and April 1, 2021, were retrospectively analyzed. SSI rates were compared among time\u2010dependent patient cohorts: Cohort A (pre\u2010pandemic,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200924,060, 87%) and Cohort B (pandemic,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20093698, 13%). Time series and multivariable analyses predicted pre\u2010pandemic and pandemic SSI trends and tested for association with timing of surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall SSI incidence was reduced in Cohort B versus Cohort A (2.8% vs. 4.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariable analysis indicated a downward SSI trend before pandemic onset (IRR 0.997, 95% CI 0.994, 1). At pandemic onset, the trend reduced by a relative factor of 39% (IRR 0.601, 95% CI 0.338, 1.069). SSI then trended upward during the pandemic (IRR 1.035, 95% CI 0.965, 1.111). SSI rates significantly trended downward in general surgical patients at pandemic onset (IRR 0.572, 95% CI 0.353, 0.928).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although overall SSI incidence was reduced during the pandemic, a statistically significant decrease in the predicted SSI rate only occurred in general surgical patients at pandemic onset. This trend may suggest a positive impact of the \u201cCOVID bundle\u201d on SSI rates in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-023-07112-3","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T12:02:19Z","timestamp":1690200139000},"page":"2310-2318","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Surgical Site Infections During the Pandemic: The Impact of the \u201cCOVID Bundle\u201d"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8229-9197","authenticated-orcid":false,"given":"Louise Catherine","family":"McLoughlin","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology (Urology) Department of Surgery University Health Network University of Toronto Toronto Canada"},{"name":"Department of Urology St. James's Hospital Dublin 8 Ireland"},{"name":"Department of Surgery Trinity College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Perlis","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology (Urology) Department of Surgery University Health Network University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Lajkosz","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology (Urology) Department of Surgery University Health Network University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Boasie","sequence":"additional","affiliation":[{"name":"Department of Surgery University Health Network University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Esmail","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Management University Health Network University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantelle","family":"Nielson","sequence":"additional","affiliation":[{"name":"Department of Quality Safety and Clinical Adoption University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Lavrencic","sequence":"additional","affiliation":[{"name":"Department of Quality Safety and Clinical Adoption University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Surgery University Health Network University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish S.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology (Urology) Department of Surgery University Health Network University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.190361"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2017.089"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.03.009"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143\u2010021\u201001513\u20105"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100041\u20101729144"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26738"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13756\u2010021\u201000982\u2010z"},{"key":"e_1_2_11_9_1","unstructured":"Center for Disease Control(2022) Available fromhttps:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/9pscssicurrent.pdf"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10896"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.112"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/JHQ.0000000000000271"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002709"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2020.05.001"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13304\u2010020\u201000884\u20106"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)32166\u20108"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.06.027"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.06.062"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","unstructured":"SullivanSG CarlsonS ChengAC ChilverMB DwyerDE IrwinMet al. 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There are no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study protocol was reviewed by the University Health Network ethics committee and received institutional review board approval, Study ID: 20-5913.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}