The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Reduction in wound infection rates by wound surveillance with postdischarge follow‐up and feedback. BJS 2006; 93: 630-638.

Published: 21st March 2006

Authors: A. P. R. Wilson, B. Hodgson, M. Liu, D. Plummer, I. Taylor, J. Roberts et al.

Background

Surgical wound surveillance with postdischarge follow‐up is rarely done in the UK as it is seen as expensive. The aim of this study was to determine whether employing a dedicated team was effective and reduced costs.

Method

Infection data were collected prospectively with postdischarge follow‐up at 2–3 months, and fed back to surgeons. Wound infection was defined using both ASEPSIS wound scoring and criteria of the US Centers for Disease Control (CDC) definitions.

Results

Over 4 years, 15 548 patient episodes were included. Postdischarge surveillance data were available for 79·9 per cent of the 15 154 records of patients who survived. There was a significant reduction in the rate of wound infection between the first and fourth years by ASEPSIS and CDC definitions: odds ratio 0·77 (95 per cent confidence interval (c.i.) 0·64 to 0·92) and 0·69 (95 per cent c.i. 0·57 to 0·83), respectively. The proportion of infections fell significantly in orthopaedic, cardiac and thoracic surgery. The annual budget for wound surveillance was £91 600. Changes in infection rates contributed £347 491 to the reduction in cost among the patients surveyed.

Conclusion

Wound surveillance was associated with a reduction in rates of wound infection within 4 years. The cost reduction as a result of fewer infections exceeded the cost of surveillance after 2 years. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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