An Incision Closure Bundle for Colorectal Surgery: 2.0 www.aornjournal.org/content/cme.

Surgical site infections (SSIs) are among the most common and expensive of all health care-associated infections, and as many as 50% are considered preventable. Surgical care bundles, which involve a small set of reliably performed evidence-based practices, may effectively reduce SSI rates. However, closure of the surgical incision is one aspect of surgical care that is not well described in current SSI prevention bundles; this presents an opportunity for perioperative professionals to improve care by identifying and implementing evidence-based incision closure practices for high-risk procedures (eg, colorectal surgery). We propose and review the evidence supporting a colorectal incision closure bundle composed of a glove and sterile instrument set change, irrigation with 0.05% chlorhexidine solution, use of triclosan-coated sutures, removal of surgical drapes after applying postoperative dressings, use of topical skin adhesive or an antiseptic dressing, and distribution of comprehensive postoperative patient instructions.