Routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection (ChEETAh): a pragmatic, cluster-randomised trial in seven low-income and middle-income countries. Issue 10365 (19th November 2022)

• Record Type: Journal Article
• Authors: Ademuyiwa, Adesoji O; Adisa, Adewale O; Bhangu, Aneel; Brocklehurst, Peter; Chakrabortee, Sohini; Ghosh, Dhruva; Glasbey, James; Haque, Parvez D; Hardy, Pollyanna; Harrison, Ewen; Ingabire, JC Allen; Ismail, Lawani; Lillywhite, Rachel; Magill, Laura; Ramos de la Medina, Antonio; Moore, Rachel; Pinkney, Thomas; Winkles, Neil; Monahan, Mark; Morton, Dion; Nepogodiev, Dmitri; Ntirenganya, Faustin; Omar, Omar; Simoes, Joana; Smith, Donna; Tabiri, Stephen; Kadir, Bryar; Ismail, Lawani; Ghosh, Dhruva; Ramos de la Medina, Antonio; Moore, Rachel; Ntirenganya, Faustin; Tabiri, Stephen; Hardy, Pollyanna; Omar, Omar; Brant, Felicity; Li, Elizabeth; Lillywhite, Rachel; Picciochi, Maria; Bahrami-Hessari, Michael; Smith, Donna; Runigamugabo, Emmy; Ahogni, Didier; Ahounou, Aristide; Boukari, K. Alassan; Gbehade, Oswald; Hessou, Thierry K; Nindopa, Sinama; Nontonwanou, M.J. Bienvenue; Guessou, Nafissatou Orou; Sambo, Arouna; Tchati, Sorekou Victoire; Tchogo, Affisatou; Tobome, Semevo Romaric; Yanto, Parfait; Gandaho, Isidore; Hadonou, Armel; Hinvo, Simplice; Hodonou, Montcho Adrien; Tamou, Sambo Bio; Lawani, Souliath; Bokossa Kandokponou, Covalic Melic; Dossou, Francis Moise; Gaou, Antoine; Goudou, Roland; Kouroumta, Marie-Claire; Lawani, Ismail; Malade, Enrif; Mkoh Dikao, Anne Stredy; Nzuwa Nsilu, Joel; Ogouyemi, Pencome; Akpla, Marcelin; Bisimwa Mitima, Nathan; Kovohouande, Blaise; Kpangon, Cyrille; Laurent Loupeda, Stephane; Victorin Agbangla, Mamonde; Emmanuel Hedefoun, Sena; Mavoha, Thierry; Ngaguene, Juvenal; Rugendabanga, Janvier; Romaric Soton, Rish; Totin, Martin; Agbadebo, Mouhamed; Akpo, Irene; Dewamon, Hubert; Djeto, Martin; Hada, Aissatou; Hollo, Monsede; Houndji, Albert; Houndote, Anasthasie; Hounsa, Sylvestre; Kpatchassou, Expedit; Yome, Hugues; Moussa Alidou, Mohamed; Jerry Bara, Eric; Dossou Yovo, B.T. Bonheur; Guinnou, Robert; Hamadou, Souleymane; Kola, H.Pauline; Moussa, Nabil; Cakpo, Boniface; Etchisse, Lolyta; Hatangimana, Emery; Muhindo, Moise; Sanni, Katia; Barthelemy Yevide, Agossou; Agossou, Hermann; Basirwa Musengo, Fiston; Behanzin, Hulrich; Morel Seto, Djifid; Armstrong Alia, Bill; Alitonou, Arnaud; Mehounou, Y.Edith; Agbanda, Lucien; Attinon, Julien; Gbassi, Marcel; Rene Hounsou, Nounagnon; Acquah, Regina; Banka, Charles; Esssien, Derick; Hussey, Romeo; Mustapha, Yakubu; Nunoo-Ghartey, Kojo; Yeboah, Grace; Adjei, Margarey N M; Adofo-Asamoah, Yvonne; Agyapong, Meshach M; Agyen, Thomas; Alhassan, Baba A B; Amoako-Boateng, Mabel P; Appiah, Anthony Baffour; Ashong, Josephine; Awindaogo, Joseph K; Brimpong, Benjamin B; Dayie, Makafui S C J K; Enti, Donald; Ghansah, Wendy W; Gyamfi, Jude E; Koggoh, Patience; Kpankpari, Richard; Kudoh, Vincent; Mensah, Samuel; Mensah, Philip; Morkor Opandoh, Isabella N; Morna, Martin T; Nortey, Michael; Odame, Emelia; Ofori, Emmanuel O; Quaicoo, Sandra; Quartson, Elizabert M; Teye-Topey, Cynthia; Yigah, Makafui; Yussif, Safia; Agyekum-Gyimah, Vera O; Agyemang, Eric; Akoto-Ampaw, Arko; Amponsah-Manu, Forster; Arkorful, Temitope E; Dokurugu, Moses A; Essel, Nanabanyin; Ijeoma, Aja; Obiri, Emmanuel L; Ofosu-Akromah, Richard; Quarchey, Karen N D; Andoh, Aaron B; Asabre, Esther; Boateng, Ruby A; Koomson, Barbara; Kusiwaa, Atta; Naah, Adeline; Oppon-Acquah, Ato; Oppong, Benjamin A; Akosua, Ameley; Armah, Ralph; Asare, Christopher; Awere-Kyere, Lawrence K B; Acquaye, Jane; Appiah, Juliana; Arthur, Joshua; Boakye-Yiadom, Jonathan; Eseenam Agbeko, Anita; Gyamfi, Frank E; Nyadu, Bertina B; Adu-Aryee, Nii A; Agboadoh, Nelson; Akoto, Erica; Amoako, Joachim K; Aperkor, Nicholas T; Asman, Wilfred K; Attepor, Godsway S; Bediako-Bowan, Antoinette A; Boakye-Yiadom, Kwaku; Brown, George D; Dedey, Florence; Etwire, Victor K; Fenu, Benjamin S; Kumassah, Philemon K; Larbi-Siaw, Linda A; Nsaful, Josephine; Olatola, David O; Tsatsu, Sandra E; Wordui, Theodore; Bennin, Amos; Doe, Stanley; Sarfo Kantanka, Ruth; Kobby, Ephraim; Kyeremeh, Collins; Osei, Edwin; Yeboah Owusu, Prince; Owusu, Frank; Sie-Broni, Clement; Zume, Marshall; Acquah, Daniel K; Adams, Shamsudeen M; Alhassan, Mohammed S; Amadu, Munira; Asirifi, Samuel A; Awe, Martin; Azanlerigu, Millicent; Dery, Mathias K; Edwin, Yenli; Atindaana Francis, Abantanga; Limann, Gbana; Maalekuu, Aloysius; Malechi, Hawa; Mohammed, Sheriff; Mohammed, Ibrahim; Mumuni, Kareem; Ofori, Bernard A; Quansah, Jonathan I K; Sam, Napoleon Bellua; Seidu, Anwar S; Tabiri, Stephen; Yahaya, Shekira; Alhassan, Jaabir; Boakye, Percy; Coompson, Christian L; Gyambibi, Addo K; Jeffery-Felix, Ametepe; Kontor, Bismark E; Manu, Ruth; Mensah, Elijah; Naah, Gifty; Noufuentes, Carmen; Sakyi, Abraham; Chaudhary, Ramkaran; Misra, Sanjeev; Pareek, Puneet; Pathak, Manish; Poonia, Dharma R; Rathod, Kirti K; Rodha, Mahaveer S; Sharma, Naveen; Sharma, Nivedita; Soni, Subhash C; Varsheney, Vaibhav K; Vishnoi, Jeevan R; Garnaik, Deepak K; Huda, Farhanul; Lokavarapu, Manoj J; Mishra, Neha; Ranjan, Rohit; Seenivasagam, Rajkumar K; Singh, Shanky; Solanki, Pratik; Verma, Raunak; Yhoshu, Enono; Kalyanapu, Jeffery A; Kutma, Ananta; Philips, Sanish; Hepzibah, Alice; Mary, Grace; Singh, Deepak S; Chetana, Chetana; Dasari, Amos; Dummala, Prashant; S, Chinta S; Bhatt, Alisha; Bhatti, William; Dhar, Tapasya; Ghosh, Dhruva N; Goyal, Ankush; Goyal, Sunita; Hans, Monika A; Haque, Parvez D; Jain, Deepak; Jain, Rita; Jyoti, Jyoti; Kaur, Savleen; Kumar, Karan; Luther, Anil; Mahajan, Amit; Mandrelle, Kavita; Michael, Vishal; Mukherjee, Partho; Rajappa, Reuben; Sam, Vivin Daniel; Singh, Prashant; Suroy, Atul; Thind, Ravinder Singh; Veetil, Sreejith K; Williams, Rahul; D, Sreekar; Daniel, Esther R; Jacob, Smitha E; Jesudason, Mark R; Kumari, Pushplatha; Mittal, Rohin; Prasad, Soosan; Samuel, Vasanth Mark; Shankar, Bharat; Sharma, Srujan; Sivakumar, Moonish V; Surendran, Suraj; Thomas, Anita; Trinity, Paul; Leshiini, K; Saluja, Sundeep S; Bansal, Ishan; Gupta, Sanjay; Gureh, Monika; Kapoor, Simran; Kanna, Vinoth; Kaur, Harmanjot; Kumar, Ashwani; Singh, Simrandeep; Singh, Gurtaj; Agrawal, Nivesh; Kumar, Uttkarsh; Kumar, Pardeep; S, Abhishek; Sehrawat, Vikram; Singla, Deepak; Thami, Gaurav; Kumar, Vijay; Mathew, Stanley; Pai, Murlidhar V; Prabhu, P S; P T, Sundeep; Chaturvedi, Arun; Gupta, Sameer; Prakash, Puneet; Rajan, Shiv; Singh, Mohit; Tripathi, Abhilasha; Alexander, Philip V; Thomas, Josy; Zechariah, Pradeep; Kichu, Moloti; Solomi, Carolin V; Choudhrie, Ashish Victor; Gunny, Rashmi Jacob; Joseph, Susan; Peters, Nitin J; Pundir, Neha; Samujh, Ram; Aziz, Gowhar; Chowdri, Nisar A; Dar, Rayees A; Kour, Robindera; Mantoo, Imtiyaz; Mehraj, Asif; Parray, Fazl Q; Saqib, Najmus; Shah, Zamir A; Wani, Rauf A; Rautela, Komal; Sharma, Rajeev; Singh, Nishu; Vakil, Rakesh; Chowdhury, Priyanka; Chowdhury, Sona; Mathai, Sonia; Nayak, Pragyanmai; Roy, Bipradas; Ascencio Díaz, Kriscia V; Avalos Herrera, Victor J; Barbosa Camacho, Francisco J; Bernal Hernández, Aldo; Bonilla Ahumada, Elyoenai; Brancaccio Pérez, Irma V; Calderón Llamas, Miguel A; Castillo Cardiel, Guadalupe; Cervantes Cardona, Guillermo A; Cervantes Guevara, Gabino; Cervantes Perez, Enrique; Chávez, Maria; Chejfec Ciociano, Jonathan M; Cifuentes Andrade, Luis R; Cortés Flores, Ana O; Cortes Torres, Edgar J; Cueto Valadez, Tania A; Cueto Valadez, Andrea E; Cueva Martinez, Esteban; Domínguez Barradas, Paulina; Esparza Estrada, Isaac; Flores Becerril, Paola; Flores Cardoza, Jose A; Fuentes Orozco, Clotilde; García González, Luis A; García Reyna, Benjamín; Gómez Sánchez, Eduardo; González Bojorquez, Jaime L; González Espinoza, Eduardo; González Ojeda, Alejandro; González Ponce, Fanny Y; Guerrero Ramírez, Cristhian S; Calderon Vanegas, Miguel Antonio; Guadalupe Cano Arias, Rocio Guadalupe; Colunga Tinajero, Carlos; Diaz Samano, Fernanda; Duque Zepeda, Fernando; Enriquez Barajas, Brenda Vanessa; Gallardo Banuelos, Gerardo; De Cristo Gonzalez Calvillo, Marijose; Ibanez Ortiz, Francisco; Lazo Ramirez, Maryzela; Lopez Arroyo, Gerardo; Montano Angeles, Laura Olivia; Morales Iriarte, David Giovanny I; Mortola Lomeli, Angelo Fernando; Esteban, Jose Esteban; Orozco Perez, Jaime; Orozco Ramirez, Damaris; Pena Baolboa, Laura Gabriela; Pizarro Lozano, Jesus; Yanowsky Reyes, Guillermo; Dominguez, Ana Camille G; Mellado, Dorihela H; Morales, Jesus Flavio M; Namur, Luz del Carmen M; Pesquera, Jose Alberto A; Ramos De la Medina, Antonio; Florencia Casado-Zarate, Ana; Delano-Alonso, Roberto; Herrera-Esquivel, Jose; Moreno-Portillo, Mucio; Trejo-Avila, Mario; Efren Lozada, Edgard; Becerra Moscoso, Mitzi R; Cabrera-Lozano, Ishtar; Calderón-Alvarado, Ana B; León-Frutos, Francisco J; Villanueva-Martínez, Erick E; Abubakar, Maimuna; Aliyu, Mohammed S; Awaisu, Mudi; Bakari, Fadimatu; Olajumoke Balogun, Abigail; Bashir, Mohammed; Bello, Ahmad; Daniyan, Muhammad; Duromola, Kehinde Michael; Gana, Stephen G; Duke George, Mukoro; Gimba, Justina; Gundu, Isaac; Onahi Iji, Lambert; Jimoh, Aminat O; Koledade, Afolabi K; Lawal, Ahmad T; Lawal, Bilkisu K; Mustapha, Aisha; Emeka Nwabuoku, Stanley; Ogunsua, Oluseyi O; Fidelis Okafor, Ifeanyi; Ike Okorie, Ethos; Oyelowo, Nasir; Saidu, Ibrahim A; Sholadoye, Tunde T; Sufyan, Ibrahim; Adetola Tolani, Musliu; Muhammad Tukur, Aliyu; Shehu Umar, Ahmad; Umar, Aminatu M; Umaru-Sule, Hajara; Usman, Mohammed; Yahya, Anisah; Yakubu, Alfa; Abeku Yusuf, Salisu; Barau Abdullahi, Lawal; Abdullahi, Muzzammil; Ado, Khadija A; Aliyu, Nura U; Chukwuemeka Anyanwu, Lofty-John; Daneji, Sulaiman M; Kawu Magashi, Mahmoud; Mohammad, Mohammad A; Bala Muhammad, Abubakar; Muhammad, Saminu S; Abodunde Muideen, Bello; Nwachukwu, Calistus U; Sallau, Suleiman B; Sheshe, Abdulrahman A; Soladoye, Abdulmajeed; Usman Takai, Idris; Umar, Garzali I; Yahaya, Abubakar; Adze, Joel A; Airede, Lydia R; Aminu, Bashiru; Bature, Stephen B; Bello-Tukur, Firdaws; Chinyio, Damai; Duniya, Sharon A N; Galadima, Moses C; Hamza, Babatunde K; Joshua, Samaila; Kache, Stephen A; Kagomi, Williams Y; Kene, Ifeanyi A; Lawal, Jamila; Makama, Jerry G; Mohammed, Caleb; Mohammed-Durosinlorun, Amina A; Nuwam, Deborah; Sale, Danjuma; Sani, Abdulrasheed; Tabara, Salome; Taingson, Mathew C; Usam, Emmanuel; Yakubu, Josiah; Adegoke, Folasade; Ige, Oluwasuyi; Odunafolabi, Tunde A; Okereke, Chukwuma E; Oladele, Oluwafemi O; Olaleye, Oluwaseun H; Olubayo, Oyetunde O; Abiola, Olukayode P; Abiyere, Henry O; Adebara, Idowu O; Adeleye, Gbadebo T C; Adeniyi, Adebayo A; Adewara, Olumide E; Adeyemo, Olabisi T; Adeyeye, Ademola A; Ariyibi, Abimbola L; Awoyinka, Babatunde S; Ayankunle, Olumide M; Babalola, Olakunle F; Bakare, Adewumi; Bakare, Tajudeen I B; Banjo, Oluseyi O; Egharevba, Peter A; Fatudimu, Oluwafemi S; Obateru, John A; Odesanya, Oluremi J; Ojo, Owolabi D; Okunlola, Abiodun I; Okunlola, Cecilia K; Olajide, Adewale T; Orewole, Tesleem O; Salawu, Adedayo I; Adelaja, Aderinsola T; Ajai, Olalekan T; Akande, Olukemi; Anyanwu, Noble; Atobatele, Kazeem M; Oluwaseyi Bakare, Oludayo; Eke, Grace; Faboya, Omolara M; Imam, Zainab O; Nwaenyi, Francisca C; Ogunyemi, Ayokunle A; Oludara, Mobolaji A; Omisanjo, Olufunmilade A; Onyeka, Chinonso U; Oshodi, Olabode A; Oshodi, Yusuf A; Oyewole, Yemisi; Salami, Omotade S; Williams, Omolara M; Adeoluwa, Adebunmi; Adesiyakan, Adedotun; Ibukunoluwa Adeyeye, Victoria; Agbulu, Moses Vincent; Akinajo, Opeyemi Rebecca; Akinboyewa, David O; Alakaloko, Felix M; Alasi, Iyabo O; Amao, Michael; Ashley-Osuzoka, Christiana; Atoyebi, Oluwole A; Balogun, Olanrewaju S; Bode, Christopher O; Oluwatobi Busari, Maryam; Duru, Nnamdi Jonathan; Edet, Glory; Elebute, Olumide A; Chinonso Ezenwankwo, Francis; Fatuga, Adedeji L; Gbenga-Oke, Christianah; Ihediwa, George C; Sylvester Inyang, Emmanuel; Jimoh, Adesola I; Oladayo Kuku, Jubril; Ladipo-Ajayi, Oluwaseun A; Lawal, Abdulrazzaq O; Makanjuola, Ayomide; Chigoze Makwe, Christian; Victoria Mgbemena, Chinelo; Nwokocha, Samuel U; Adebisi Ogunjimi, Moses; Okwudiri Ohazurike, Ephraim; Ojewola, Rufus W; Eunice, Moyosoluwa Eunice; Okeke, Chike J; Okunowo, Adeyemi A; Oladimeji, Abraham T; Olajide, Thomas O; Olanrewaju, Olabisi; Olayioye, Olawunmi; Oluseye, Oluwaseun O; Olutola, Stephen; Onyekachi, Kenneth; Ayoola Orowale, Adeola; Osariemen, Emili; Olumide Osinowo, Adedapo; Osunwusi, Benedetto; Owie, Emmanuel; Bidemi Oyegbola, Christianah; Seyi-Olajide, Justina O; Soibi-Harry, Adaiah P; Talla Timo, Manuella; Okechukwu Ugwu, Aloy; Ojo Williams, Emmanuel; Egwuonwu, Ochonma A; Hyginus Ekwunife, Okechukwu; Emeka, James J; Ifeanyichukwu Modekwe, Victor; Nwosu, Chimdiebele Daisy; Obiechina, Sylvester O; Obiesie, Ahuizechukwu E; Okafor, Celestine I; Okonoboh, Theophilus O; Okoro, Chukwuemeka; Okoye, Odili A; Onu, Onyekachi A; Onyejiaka, Chukwudubem C; Faith Uche, Chisom; Ugboajah, Joseph O; Okechukwu Ugwu, Jideofor; Ugwuanyi, Kenneth; Ugwunne, Chuka; Adeleke, Akeem A; Adepiti, Akinfolarin C; Aderounmu, Adewale A; Adesunkanmi, Abdulhafiz O; Ajekwu, Samuel C; Ajenifuja, Olusegun K; Alatise, Olusegun I; Badmus, Tajudeen A; Mohammed, Tajudeen O; Olasehinde, Olalekan; Salako, Abdulkadir A; Sowande, Oludayo A; Talabi, Ademola O; Wuraola, Funmilola O; Aderemi Adegoke, Paul; Akinloye, Abidemi; Akinniyi, Ayodeji; Ejimogu, Joseph; Eseile, Ideyonbe Samuel; Olaolu Ogundoyin, Olakayode; Okedare, Amos; Olulana, Dare Isaac; Omotola, Omolara; Sanwo, Francis; Ajagbe, Adewale O; Akintunde, Olugbenga P; Asafa, Opeyemi Q; Awodele, Kehinde; Eziyi, Amogu K; Fasanu, Adeniyi O; Ojewuyi, Olufemi O; Ojewuyi, Abiodun R; Oyedele, Abisola E; Taiwo, Oluwaseun A; Adewole, Nathaniel D; Agida, Teddy E; Ailunia, Eunice E; Aisuodionoe-Shadrach, Oseremen; Akaba, Godwin O; Alfred, Janet; Atim, Terkaa; Bawa, Kehinde G; Chinda, John Y; Daluk, Esther B; Eniola, Sefiu B; Ezenwa, Augusta O; Garba, Stephen E; Mbajiekwe, Ndubuisi; Mshelbwala, Philip M; Ndukwe, Ngozi O; Ogolekwu, Idoko P; Ohemu, Alexander A; Olori, Samson; Osagie, Olabisi O; Sani, Samuel A; Suleiman, Salisu; Sunday, Helen; Tabuanu, Nancy O; Umar, Aminu M; Arekhandia, Alexander I; Edena, Morrison E; Eghonghon, Raymond A; Enaholo, Joel E; Ida, Genesis; Ideh, Stanley N; Iribhogbe, Oseihie I; Irowa, Omorodion O; Isikhuemen, Maradona E; Odutola, Oluwatomi R; Okoduwa, Kester O; Omorogbe, Scott O; Oruade, David; Osagie, Osasumwen T; Osemwegie, Osarenkhoe; Abdus-Salam, Rukiyat A; Adekola Adebayo, Sikiru; Ajagbe, Oluwasanmi A; Ajao, Akinlabi E; Ajibola, Gboyega; Ayandipo, Omobolaji O; Egbuchulem, Kelvin I; Ekwuazi, Hyginus O; Elemile, Peter; Fakoya, Adegbolahan; Idowu, Oluwasegun C; Irabor, David O; Lawal, Taiwo A; Lawal, Olatunji O; Ogundoyin, Olakayode O; Ojediran, Oluwabukade; Olagunju, Naomi; Sanusi, Akinsola T; Takure, Augustine O; Oluwadamilola Adebisi, Mary; Abiola Adeleke, Nurudeen; Tinuola Afolabi, Rafiat; Ishola Aremu, Isiaka; Oyekunle Bello, Jibril; Bello, Robiat; Lawal, Abdulwahab; Abolade Lawal, Saheed; Ojajuni, Adeolu; Oyewale, Sabur; Olaide Raji, Hadijat; Sayomi, Olayinka; Shittu, Asimiyu; Igwe, Patrick O; Enyinnaya Iweha, Ikechukwu; John, Raphael E; Okoi, Nnyonno; Okoro, Philemon E; Kingsley Oriji, Vaduneme; Oweredaba, Ibiene T; Mutimamwiza, Immaculee; Nirere, Francoise; Niyongombwa, Irenee; Dukuzimana, Rongin; Aimable Habiyakare, Jean; Gloriose Nabada, Marie; Uwizeye, Marcel; Ingabire, Faustine; Karekezi, Aloys; Masengesho, Jean Pierre; Mpirimbanyi, Christophe; Mukamazera, Lydia; Mukangabo, Clemence; Niyomuremyi, Jean Paul; Ntwari, Gabriel; Seneza, Celestin; Umuhoza, Divine; Imanishimwe, Alphonsine; Kanyarukiko, Salathiel; Dusabimana, Anaclet; Kanyesigye, Sam; Mukaneza, Francine; Mukantibaziyaremye, Deborah; Munyaneza, Aphrodis; Ndegamiye, Gibert; Nyirangeri, Pierrine; Tubasiime, Ronald; Claude Uwimana, Jean; Izabiriza, Emelyne; Maniraguha, Hope Lydia; Mpirimbanyi, Christophe; Mutuyimana, Josiane; Mwenedata, Olivier; Rwagahirima, Elisee; Zirikana, Job; Umuhoza, Josine; Uwayezu, Roda; Uzikwambara, Leoncie; Kabanda, Elysee; Mbonimpaye, Salomee; Mukakomite, Christine; Muroruhirwe, Piolette; Dusabeyezu, Moise; Mukasine, Athanasie; Utumatwishima, Jean N; Bucyibaruta, Georges; Habumuremyi, Sosthene; de Dieu Haragirimana, Jean; Imanishimwe, Alphonsine; Ingabire, Allen JC; Mukanyange, Violette; Munyaneza, Emmanuel; Mutabazi, Emmanuel; Mwungura, Espoir; Ncogoza, Isaie; Ntirenganya, Faustin; Nyirahabimana, Jeannette; Nyirasebura, Dancilla; Urimubabo, Christian Jean; Adams, Mary Augusta; Jeffrey Ede, Chikwendu; Hyman, Gabriella; Nosipho Mathe, Mpho; Moore, Rachel; Anthea Nhlabathi, Ncamsile; Samkelisiwe Nxumalo, Hlengiwe; Sentholang, Nnosa; Sethoana, Mmule Evelyn; Wondoh, Paul; Domingo, Aimee; Munda, Philip; Nyatsambo, Chido; Ojo, Victor; Pswarayi, Rudo; Jayne, David; Laurberg, Soeren; Smart, Neil; Cousens, Simon; Aniakwo, Luke A; Adjei-Acquah, Esther; Adam-Zakariah, Leslie; Agbowada, Emma A; Acheampong, Dorcas O; Abdulai, Samira; Abdul-Aziz, Iddrisu I A; Adobea, Vivian; Abdul-Hafiz, Saba; Kojo Acquah, Emmanuel; Chaudhary, Ramkaran; Garnaik, Deepak K; John, Suzan; Gautham, Arun K; Abraham, Eunice S; Bhatt, Alisha; D, Sreekar; Kanchodu, Sudheer; Attri, Ashok K; Aggarwal, Manisha; John, Viju; Adnan, Mohammed; Ismavel, Vijay A; Akhtar, Naseem; Alpheus, Rahul A; Malik, Muneer A; Ahmed, Hafsa I; Raul, Subrat; Alvarez Villaseñor, Andrea S; Aguilar Mata, Jesus Antonion; Castillo, Monica N; Martinez Perez Maldonado, Laura; Bozada-Gutierrez, Katya; Cethorth Fonseca, Roland Kevin; Ambriz-González, Gabriela; Abdullahi, Aisha; Abdulkarim, Abdulhafiz A; Abdulrasheed, Lubabatu; Adegoke, Folasade; Abiola, Olukayode P; Abdulsalam, Moruf A; Abunimye, Esther; Duruewuru, Innocent O; Adeleke, Akeem A; Aderemi Adegoke, Paul; Adumah, Collins C; Abdullahi, Habiba I; Agbonrofo, Peter I; Abdus-Salam, Rukiyat A; Olajide Abdur-Rahman, Lukman; Abhulimen, Victor; Mizero, Japhet; Majyabere, Jean Paul; Byaruhanga, Anastase; Ruhosha, Mathias; Igiraneza, Joselyne; Habumuremyi, Sosthene; Dusabe, Moses; Sibomana, Isaie; Rubanguka, Desire; Dieudonne Hirwa, Aime; Butana, Herbert; Batangana, Mediatrice; Dusabimana, Anaclet; Fourtounas, Maria; Cook, Jonathan; Brown, Julia;
• Is Part Of: Lancet. Volume 400:Issue 10365(2022)
• Page Start: 1767
• Page End: 1776
• Publication Date: 2022-11-19
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(22)01884-0
• Languages: English
• ISSNs: 0140-6736

Abstract

Summary: Background: Surgical site infection (SSI) remains the most common complication of surgery around the world. WHO does not make recommendations for changing gloves and instruments before wound closure owing to a lack of evidence. This study aimed to test whether a routine change of gloves and instruments before wound closure reduced abdominal SSI. Methods: ChEETAh was a multicentre, cluster randomised trial in seven low-income and middle-income countries (Benin, Ghana, India, Mexico, Nigeria, Rwanda, South Africa). Any hospitals (clusters) doing abdominal surgery in participating countries were eligible. Clusters were randomly assigned to current practice (42) versus intervention (39; routine change of gloves and instruments before wound closure for the whole scrub team). Consecutive adults and children undergoing emergency or elective abdominal surgery (excluding caesarean section) for a clean–contaminated, contaminated, or dirty operation within each cluster were identified and included. It was not possible to mask the site investigators, nor the outcome assessors, but patients were masked to the treatment allocation. The primary outcome was SSI within 30 days after surgery (participant-level), assessed by US Centers for Disease Control and Prevention criteria and on the basis of the intention-to-treat principle. The trial has 90% power to detect a minimum reduction in the primary outcome from 16% to 12%, requiring 12 800 participants from at least 64 clusters. The trial was registered with ClinicalTrials.gov, NCT03700749 . Findings: Between June 24, 2020 and March 31, 2022, 81 clusters were randomly assigned, which included a total of 13 301 consecutive patients (7157 to current practice and 6144 to intervention group). Overall, 11 825 (88·9%) of 13 301 patients were adults, 6125 (46·0%) of 13 301 underwent elective surgery, and 8086 (60·8%) of 13 301 underwent surgery that was clean–contaminated or 5215 (39·2%) of 13 301 underwent surgery that was contaminated–dirty. Glove and instrument change took place in 58 (0·8%) of 7157 patients in the current practice group and 6044 (98·3%) of 6144 patients in the intervention group. The SSI rate was 1280 (18·9%) of 6768 in the current practice group versus 931 (16·0%) of 5789 in the intervention group (adjusted risk ratio: 0·87, 95% CI 0·79–0·95; p=0·0032). There was no evidence to suggest heterogeneity of effect across any of the prespecified subgroup analyses. We did not anticipate or collect any specific data on serious adverse events. Interpretation: This trial showed a robust benefit to routinely changing gloves and instruments before abdominal wound closure. We suggest that it should be widely implemented into surgical practice around the world. Funding: National Institute for Health Research (NIHR) Clinician Scientist Award, NIHR Global Health Research Unit Grant, Mölnlycke Healthcare.