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Surgical wound infection
1Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112.
Abstract:
Wound infections remain a major source of postoperative morbidity, accounting for about a quarter of the total number of nosocomial infections. Today, many of these infections are first recognized in the outpatient clinic or in the patient's home due to the large number of operations done in the outpatient setting. This leads to errors in establishing the true incidence of their occurrence but undoubtedly decreases the overall real cost and length of hospital stay. The pathogens implicated in the development of wound infections remain largely the human microorganisms from the exogenous environment and the endogenous organ microflora. Many perioperative factors have been identified that increase the incidence of the development of postoperative wound infection. Avoidance of these factors as well as the appropriate use of perioperative antibiotic prophylaxis has decreased the incidence of wound infection. During the last decade many studies have reported on the individual risk factors that favor the development of postoperative infectious complications in various surgical procedures. It is hoped that this knowledge may allow for prospective alterations in the preventative and therapeutic modalities in the high-risk patient in the studies designed in the 1990s. The use of effective infection surveillance both in the hospital and in the outpatient setting is mandatory in order to collect meaningful data. The use of computer technology will greatly facilitate the proper surveillance, analysis, and control of infections in the surgical patient.
Insights
Preventing postoperative wound infections is crucial for reducing patient morbidity and healthcare costs. Identifying and mitigating risk factors, alongside antibiotic prophylaxis and robust surveillance, are key strategies for infection control.
Area of Science:
- Infectious Diseases
- Surgical Site Infections
- Public Health
Background:
- Wound infections are a significant cause of postoperative morbidity, representing approximately 25% of nosocomial infections.
- The shift towards outpatient surgery complicates accurate incidence tracking but reduces hospital stay and costs.
- Common pathogens include human microorganisms from external sources and endogenous flora.
Purpose of the Study:
- To review identified perioperative risk factors for postoperative wound infections.
- To emphasize the importance of avoiding these risk factors and using antibiotic prophylaxis.
- To highlight the need for effective surveillance and data analysis for infection control.
Main Methods:
- Literature review of studies on individual risk factors for postoperative infectious complications.
- Analysis of factors influencing wound infection incidence.
- Discussion of preventative and therapeutic strategies.
Main Results:
- Numerous perioperative factors increase the risk of postoperative wound infections.
- Avoiding risk factors and using antibiotic prophylaxis effectively reduce infection rates.
- Studies from the 1990s provided insights for high-risk patient management.
Conclusions:
- Knowledge of risk factors enables prospective adjustments in preventative and therapeutic approaches.
- Effective infection surveillance in both inpatient and outpatient settings is mandatory.
- Computer technology can significantly aid in infection surveillance, analysis, and control.