UNDERESTIMATION OF SURGICAL SITE INFECTION-RATES IN OBSTETRICS AND GYNECOLOGY

被引:28
作者
GRAVELTROPPER, D
OXLEY, C
MEMISH, Z
GARBER, GE
机构
[1] Occupational Health and Safety, Infection Control Service University of Ottawa, Ottawa, Ont.
[2] Division of Infectious Diseases, Department of Medicine Ottawa, Ont.
[3] Ottawa General Hospital, University of Ottawa, Ottawa, Ont.
关键词
D O I
10.1016/0196-6553(95)90004-7
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: With the increasing volume of same-day operations and shortened hospital stays, it becomes more likely that a significant percentage of surgical site infections will occur after these patients' discharges. Methods: To document the true incidence of postdischarge surgical site infection, surveillance was undertaken in a group of obstetric and gynecologic patients. The study consisted of two parts. (1) A questionnaire was mailed to each surgeon, inquiring about clinical evidence of infection. The infection control service continued to do surveillance of wound infection in the usual manner, and the results of the two methods were compared. (2) A questionnaire was provided to patients undergoing operation, inquiring about signs and symptoms of wound infection. Results: A total of 469 surgical procedures were included, with a total of 24 infections detected (5.2%). Of these, 14 infections (58.3%) were detected by the usual surveillance method. An additional 10 infections (41.7%) were detected after patient discharge by the physician questionnaire. Only two of the 24 infections were detected by the patient questionnaire. Conclusions: Failure to include postdischarge surgical site surveillance results in a substantial underestimation of the true surgical site infection rate. Physician input and strong support have prompted a regular biannual postdischarge surgical site surveillance program in this patient population.
引用
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页码:22 / 26
页数:5
相关论文
共 25 条
[1]  
Centers for Disease Control, Nosocomial infections surveillance, 1983, MMWR, 33, pp. 9SS-21SS, (1984)
[2]  
Trumbore, Kaye, Changing patterns of hospital associated infections, Infect Surg, 4, pp. 34-41, (1985)
[3]  
Haley, Culver, White, Et al., The nationwide infection rates: a new need for vital statistics, Am J Epidemiol, 121, pp. 159-167, (1985)
[4]  
Green, Wenzel, Post-operative wound infection: a controlled study of the increased duration of hospital stay and direct cost of hospitalization, Ann Surg, 185, pp. 264-268, (1977)
[5]  
Beyt, Troxler, Cavaness, Prospective payment and infection control, Infect Control, 6, pp. 161-164, (1985)
[6]  
Farber, Reimbursement for nosocomial infections under the prospective payment plan: the future or decline of infection control, Infect Control, 5, pp. 425-426, (1984)
[7]  
Rubenstein, Green, Modan, Et al., The effects of nosocomial infections on the length and costs of hospital stay and direct cost of hospitalization, Annals of Surgery, 185, pp. 264-268, (1977)
[8]  
Wenzel, Nosocomial infections, diagnosis related groups, and study on the efficacy of nosocomial infection control, Am J Med, 78, pp. 3-7, (1985)
[9]  
Haley, Culver, White, Et al., The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals, Am J Epidemiol, 121, pp. 182-205, (1985)
[10]  
Olson, Lee, Continuous 10-year wound infection surveillance: results, advantages and unanswered questions, Arch Surg, 125, pp. 794-803, (1990)