Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-19T07:23:58.234Z Has data issue: false hasContentIssue false

Surgical Wound Infections: Prospective Study of 4,468 Clean Wounds

Published online by Cambridge University Press:  02 January 2015

M.J. Gil-Egea*
Affiliation:
Departments of Surgery, Medicine, and Biostatistics, Hospital de Nostra Senyora del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
M.T. Pi-Sunyer
Affiliation:
Departments of Surgery, Medicine, and Biostatistics, Hospital de Nostra Senyora del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
A. Verdaguer
Affiliation:
Departments of Surgery, Medicine, and Biostatistics, Hospital de Nostra Senyora del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
F. Sanz
Affiliation:
Departments of Surgery, Medicine, and Biostatistics, Hospital de Nostra Senyora del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
A. Sitges-Serra
Affiliation:
Departments of Surgery, Medicine, and Biostatistics, Hospital de Nostra Senyora del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
L. Torre Eleizegui
Affiliation:
Departments of Surgery, Medicine, and Biostatistics, Hospital de Nostra Senyora del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
*
Department of Surgery, Hospital de Nostra Senyora del Mar, Passeig Maritim sin, OSOOS Barcelona, Spain

Abstract

A prospective four-year study on the infection rate of clean operative wounds is presented. From January 1982 to June 1985, a nurse epidemiologist and a medical team assessed 4,468 operative procedures, from the day of surgery to the patients' discharge from the hospital. The infection rate was 3.2%. A higher incidence of wound infection was detected in patients requiring emergency operations (5.1%), in drained wounds (5.4%), and in patients with conditions thought to predispose to infection, such as advanced cancer, hepatic cirrhosis, diabetes, nephrotic syndrome, previous splenectomy, and treatment with immunosuppressive drugs (7.8%). Age over 65 did not influence infection rates. There were up to tenfold differences in infection indices between surgeons performing the same clean procedures. The continued monitoring of clean wound infection rates allowed the early detection and control of infection outbreaks. Providing periodic information on infection rates to the different surgical services was associated with decreasing infection rates over time.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Altemeier, WA, Surgical infections: Incisional wounds, in Bennet, JV, Brachman, PS (eds): Hospital Infections. Boston, Little Brown & Co, 1979.Google Scholar
2.Brachman, PS, Dan, BB, Haley, RW, et al: Nosocomial surgical infections: Incidence and cost. Surg Clin North Am 1980;60:8392.CrossRefGoogle ScholarPubMed
3.Green, JW, Wenzel, RP, Postoperative wound infection. Ann Surg 1977;185:264268.CrossRefGoogle ScholarPubMed
4.Cruse, JPF, Foord, R, The epidemiology of wound infection: A 10-year prospective study of 62,939 wounds. Surg Clin North Am 1980;60:2740.Google Scholar
5.Swartz, L, The cost of hospital infections. Presented at First Symposium on Control of Surgical Infections, American College of Surgeons, Fort Lauderdale, Florida, 1970, pp 57.Google Scholar
6.Polk, HC, Prevention of surgical wound infection. Ann Intern Med 1978;89:770773.Google Scholar
7.National Academy of Sciences-National Research Council. Postoperative wound infections: The influence of ultraviolet irradiations of the operating room and of various other factors. Ann Surg (suppl 2) 1964;160:1192.Google Scholar
8.Sandusky, WR, Use of prophylactic antibiotics in surgical patients. Surg Clin North Am 1980;60:1525.Google Scholar
9.Conte, JE, Jacob, LS, Polk, HC, Antibiotic Prophylaxis in Surgery. Philadelphia, Lippincott, 1984, p 15.Google Scholar
10.Polk, HC, Lopez Mayor, JF, Postoperative wound infection: A prospective study of determinant factors and prevention. Surgery 1969;66:97103.Google Scholar
11.Cruse, JPE, Foord, R, A five-year prospective study of 23,649 surgical wounds. Arch Surg 1973;107:206210.CrossRefGoogle Scholar