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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 evidencebased 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 evidencebased incision closure practices for highrisk 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 triclosancoated 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.