# Impact of Polyhexanide Care Bundle on Surgical Site Infections in Paediatric and Neonatal Cardiac Surgery: A Propensity Score‐Matched Retrospective Cohort Study

## TL;DR

A new care bundle using PHMB significantly reduced surgical site infections in children and neonates undergoing heart surgery.

## Contribution

This study demonstrates the effectiveness of a PHMB-based care bundle in reducing SSIs in pediatric and neonatal cardiac surgery.

## Key findings

- The PHMB care bundle reduced SSIs from 7.1% to 1.8% compared to conventional care.
- Propensity score matching confirmed the results in comparable patient groups.

## Abstract

The primary aim of this study was to evaluate the impact of the polyhexamethylene biguanide (PHMB) care bundle on the occurrence rates of surgical site infections (SSIs) in paediatric and neonatal cardiac surgery, addressing a critical gap in paediatric‐specific infection prevention protocols. A retrospective cohort study included patients under 18 years old who underwent cardiac surgery at IRCCS Policlinico San Donato. Cohort A (n = 117) received the PHMB care bundle from April to December 2023, while Cohort B (n = 801) received conventional care from September 2020 to March 2023. The 1:1 propensity score matching was used to balance covariates between cohorts, resulting in two comparable cohorts (Cohort A = 114 patients and Cohort B = 112). The study found a significant reduction in SSIs among patients receiving the PHMB care bundle compared with those receiving conventional care (1.8% vs. 7.1%, p = 0.048). The comprehensive nature of the PHMB care bundle, including educational programs, preoperative and postoperative antimicrobial treatments, and consistent application of best practices, was instrumental in achieving these outcomes. Implementing antimicrobial care bundles could significantly reduce SSIs in paediatric cardiac surgery. Future research is needed to refine the tested bundle with prospective approaches.