Effect of surgical safety checklist on colorectal surgical site infection rates in 2 countries: Brazil and Canada.

Background: The effectiveness of the surgical safety checklist (SSC) in countries with different socioeconomic backgrounds is uncertain. To evaluate the effect of the SSC in 2 different socioeconomic settings, we compared surgical site infection (SSI) rates before and after its implementation in colorectal procedures.

Methods: An epidemiological retrospective study was conducted in the university hospitals in Ottawa, Canada, and Belo Horizonte, Brazil. Data were collected through chart review from the period before and after the SSC implementation.

Results: The SSI rate decreased from 27.7%-25.9% (P = .625) and from 17.0%-14.4% in Canada and Brazil, respectively (P = .448) after the SSC implementation. In Canada, there was no SSI in incomplete SSC, and in Brazil, SSI was 20.0% (P = .026).

Discussion: Despite high and regular completion of the SSC in the Canadian and Brazilian hospitals, respectively, there was no significant reduction of SSI after the SSC implementation in any setting. However, in Brazil, the association between incomplete SSC and higher SSI rates demonstrated the potential impact of the SSC in developing countries.

Conclusions: The effect of the SSC on SSI may be greater in developing countries due to minor investment and consolidation of policies in SSI prevention.