Postoperative wound infection: indicator of clinical quality?

This study aims to gain experience with continuous electronic registration of data regarding postoperative wound infection following heart surgery.

Every patient undergoing cardiac surgery from February 1999 to May 1999 was included in a prospective study and followed for 30 days. Data regarding type of operation, development of postoperative wound infection, risk factors for wound infection and a risk stratification were submitted electronically to a central database.

All 180 operations were registered in the database, and risk variables were registered for all patients but one (99.4%). A spot test comprising 32% of 131 operations registered at the time of the spot test, showed a predictive value of a correctly applied diagnosis of wound infection at 78%. Only 4/7 (57%) of infections in the spot test were registered in the database. All deep wound infections were registered during the study period.

Data, including risk stratification, in relation to postoperative wound infection following heart surgery can be registered continuously in a central database. Registration of all wound infections, however, requires several resources and may be incomplete. The present registration's good level of cover concerning deep wound infection and risk variables indicates, that deep wound infection may provide a meaningful indicator of clinical quality, although good risk variables still need to be developed.