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Decreasing the Incidence of Surgical Wound Infections: Validation of a Surveillance-Notification Program

Decreasing the Incidence of Surgical Wound Infections: Validation of a Surveillance-Notification... Abstract • In an attempt to validate the observations of a previously published ten-year study of surgical wounds, we studied 8,474 wounds over an 18-month period using a protocol nearly identical to that of the previous study. Our study corroborated the following predictors of clean-wound infection: increasing duration of surgery, age less than 1 or greater than 50 years, increasing duration of preoperative hospitalization, use of drains, and shaving and emergency surgery. We failed to corroborate use of wound irrigation as a protective measure or time of preoperative shaving as a significant variable. Most importantly, we found a 42% reduction in the clean-wound infection rate during the study period (1.9% to 1.1%), adding support to the concept that a wound surveillance program with surgeon notification is both efficacious and cost-effective. (Arch Surg 1986;121:458-461) References 1. Cruse PJE, Foord R: A five-year prospective study of 23,649 surgical wounds . Arch Surg 1973;107:206-210.Crossref 2. Cruse PJE, Foord R: The epidemiology of wound infection: A ten-year prospective study of 62,939 wounds . Surg Clin North Am 1980;60:187-196. 3. Simmons BP: CDC guideline for prevention of surgical wound infections . Infect Control 1982;3:187-196. 4. Altemeir WA, Burke JF, Pruitt BA, et al: Manual on the Control of Infection in Surgical Patients . Philadelphia, JB Lippincott Co, 1976. 5. Olson M, O'Connor M, Schwartz ML: Surgical wound infections: A five-year prospective study of 20,193 wounds at the Minneapolis VA Medical Center . Ann Surg 1984;199:253-259.Crossref 6. Seropian R, Reynolds BM: Wound infections after preoperative depilatory versus razor preparation . Am J Surg 1971;121:251-254.Crossref 7. Brachman PS, Dan BB, Haley RW, et al: Nosocomial surgical infections: Incidence and cost . Surg Clin North Am 1980;60:15-25. 8. Haley RW, Morgan WM, Culver DH, et al: Hospital infection control: Recent progress and opportunities under prospective payment . Am J Infect Control 1985;13:97-108.Crossref 9. Condon RE, Schulte WJ, Malangon MA, et al: Effectiveness of a surgical wound surveillance program . Arch Surg 1983;118:303-307.Crossref 10. Haley RW, Culver DH, White JW, et al: The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals . Am J Epidemiol 1985;121:182-205. 11. Haley RW: Surveillance by objective: A new priority-directed approach to the control of nosocomial infections . Am J Infect Control 1985;13:78-89.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Decreasing the Incidence of Surgical Wound Infections: Validation of a Surveillance-Notification Program

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Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1986.01400040096015
Publisher site
See Article on Publisher Site

Abstract

Abstract • In an attempt to validate the observations of a previously published ten-year study of surgical wounds, we studied 8,474 wounds over an 18-month period using a protocol nearly identical to that of the previous study. Our study corroborated the following predictors of clean-wound infection: increasing duration of surgery, age less than 1 or greater than 50 years, increasing duration of preoperative hospitalization, use of drains, and shaving and emergency surgery. We failed to corroborate use of wound irrigation as a protective measure or time of preoperative shaving as a significant variable. Most importantly, we found a 42% reduction in the clean-wound infection rate during the study period (1.9% to 1.1%), adding support to the concept that a wound surveillance program with surgeon notification is both efficacious and cost-effective. (Arch Surg 1986;121:458-461) References 1. Cruse PJE, Foord R: A five-year prospective study of 23,649 surgical wounds . Arch Surg 1973;107:206-210.Crossref 2. Cruse PJE, Foord R: The epidemiology of wound infection: A ten-year prospective study of 62,939 wounds . Surg Clin North Am 1980;60:187-196. 3. Simmons BP: CDC guideline for prevention of surgical wound infections . Infect Control 1982;3:187-196. 4. Altemeir WA, Burke JF, Pruitt BA, et al: Manual on the Control of Infection in Surgical Patients . Philadelphia, JB Lippincott Co, 1976. 5. Olson M, O'Connor M, Schwartz ML: Surgical wound infections: A five-year prospective study of 20,193 wounds at the Minneapolis VA Medical Center . Ann Surg 1984;199:253-259.Crossref 6. Seropian R, Reynolds BM: Wound infections after preoperative depilatory versus razor preparation . Am J Surg 1971;121:251-254.Crossref 7. Brachman PS, Dan BB, Haley RW, et al: Nosocomial surgical infections: Incidence and cost . Surg Clin North Am 1980;60:15-25. 8. Haley RW, Morgan WM, Culver DH, et al: Hospital infection control: Recent progress and opportunities under prospective payment . Am J Infect Control 1985;13:97-108.Crossref 9. Condon RE, Schulte WJ, Malangon MA, et al: Effectiveness of a surgical wound surveillance program . Arch Surg 1983;118:303-307.Crossref 10. Haley RW, Culver DH, White JW, et al: The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals . Am J Epidemiol 1985;121:182-205. 11. Haley RW: Surveillance by objective: A new priority-directed approach to the control of nosocomial infections . Am J Infect Control 1985;13:78-89.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1986

References