Effectiveness of Safety Control in Surgical Care for Patients with Abdominal Sepsis

Relevance. Improving surgical outcomes in patients with abdominal sepsis, including enhancing the quality and safety of care by preventing diagnostic and treatment-related errors, remains a top priority in emergency medicine.

Aim of the Study. To perform a comparative clinical analysis of the effectiveness of surgical safety control based on the implementation of an improved checklist titled “Preventive Measures Checklist for Defects in Surgical Care for Abdominal Sepsis”.

Material and Methods. This retrospective and prospective controlled clinical study included 49 patients with abdominal sepsis resulting from secondary postoperative diffuse purulent peritonitis. The patients received comprehensive treatment programs that involved different approaches to controlling and preventing surgical care defects. In the comparison group A (31 patients), the improved checklist was used retrospectively by analyzing primary medical records to identify previously occurred defects in surgical care. In the main group B (18 patients), the same checklist was applied prospectively during the actual surgical care process.

Results. The controlled comparative clinical study demonstrated a statistically significant reduction in the number of surgical care defects, the severity of endogenous intoxication, the incidence of postoperative complications, and the duration of hospital stay in patients with abdominal sepsis when the improved checklist was integrated into the treatment protocol.

Conclusion. Prospective application of the improved surgical safety checklist significantly reduced the frequency of documentation errors from 38.7–67.7% to 11.1–0% (p<0.05); diagnostic errors from 80.6% to 0% (p><0.05); preoperative and intraoperative management errors from 19.4–74.2% to 16.7–0% (p><0.05); and postoperative care errors from 6.5–83.9% to 11.1–0% (p><0.05). > < 0.05); diagnostic errors from 80.6% to 0% (p < 0.05); preoperative and intraoperative management errors from 19.4–74.2% to 16.7–0% (p < 0.05); and postoperative care errors from 6.5–83.9% to 11.1–0% (p < 0.05).

The effectiveness of the improved surgical safety checklist is further evidenced by a significant decrease in serum markers of endogenous intoxication (p < 0.05), increased bioelectrical activity of the small intestine (p < 0.05), and reduced postoperative complications — including intra-abdominal abscesses (from 45.2% to 11.1%, p=0.05), eventrations (from 35.5% to 0%, p=0.03), and pulmonary complications (from 61.3% to 11.1%, p=0.05). The length of hospital stay among survivors also decreased significantly from 39.3±2.1 to 22.5±1.1 days (p=0.002).

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