RT Journal
A1 Makary MA, Ibrahim AM
T1 SUrgical care improvement project adherence and postoperative infections
JF JAMA
JO JAMA
YR 2010
FD October 20
VO 304
IS 15
SP 1669
OP 1672
DO 10.1001/jama.2010.1462
UL http://dx.doi.org/10.1001/jama.2010.1462
AB 
To the Editor: The study by Dr Stulberg and colleagues1 affirmed the concern that, although SCIP has been a landmark step in translating evidence into measurement in surgery, the measures were based on many studies that used outcomes unadjusted for the risk of infection. Obesity alone may account for up to a 50% variation in postoperative infection rates.2 In addition, half of the SCIP measures involve antibiotics, which do not penetrate avascular areas prone to infection such as dead space in closed wounds and deep fluid collections.