Design: Pre and Post-intervention quality improvement study. Baseline surgical site infection, urinary tract infection, and antibiotic use data were collected from January 1st, 2020, to December 31st, 2021. Patients who underwent a laparoscopic hysterectomy between March 1st, 2022, and March 1st, 2023, were included in the post-intervention arm. Fischer exact test was performed for statistical significance. Primary outcome was the reduction of SSI within 30 days after surgery.

Setting: A community hospital that is part of a large health system in Minnesota. The intervention is applied in the operating room after positioning the patient in dorsal lithotomy and administration of general anesthesia.

Patients or Participants: All patients undergoing a laparoscopic or robotic hysterectomy in the study duration were included.

Interventions: After proper positioning, the anus is cleansed using chlorhexidine-alcohol swabs. The Anal mucosa is covered with a 2x2 in gauze and secured in place with a band-aid to protect the mucosa. A 10x20 cm Ioban Incise Surgical Drape is applied to the perineal body and the surrounding perianal skin to isolate the anal orifice from the surgical field. The rest of the skin and perineum are prepped per standard protocol.

Measurements and Main Results: post-intervention data (n=81) showed a 63% reduction in SSI (P=0.43) and a 45% decrease in UTI rates. Declines were also noted in post-operative antibiotics prescribing from 17.4% to 6.2%.

Conclusion: Decontamination of the perianal skin and isolation may have a role in reducing hysterectomy-related infectious morbidity. Because of our small sample size, dissemination of the intervention on a broader scale is critical to provide statistically meaningful data.