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Updated: Jun 3, 2026
Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds
Published on: October 20, 2012
The impact of mixing surgical subspecialty patients on wound infection rates
Mohiemen Anwar1, Louisa Ferguson, Zaid Awad
1Department of Otolaryngology, Head and Neck Surgery, Barts and the London NHS Trust, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK.
Abstract:
To investigate the impact of mixing surgical subspecialty patients on post-operative wound infections. A retrospective analysis of post-operative wound infections in head and neck surgery patients before and after mixing them with urology patients. We selected two periods that are identical in duration and seasonal spread. The first was from March 2005 to November 2005 and the second was from March 2006 to November 2006. 1,381 patients underwent head and neck surgery at our institution in the two periods; 705 in the first and 676 in the second. Excluding MRSA positive swabs, the rate of positive swabs or "episodes" was 4% in the first group (2005) and 10% in the second group (2006). The monthly breakdown showed a significant increase in the second group (2006) (p = 0.024). Uro-genital microorganisms were the main factor contributing to the increase in wound infection rates in the second period (p = 0.008). Other organisms like MRSA, remained statistically unchanged (p = 0.464). It is recommend that head and neck surgery patients are better managed on separate wards. Clinicians should have a low threshold of suspecting a broader range of microorganisms when other specialty patients are on the same ward.
Insights
Mixing head and neck surgery patients with urology patients significantly increased post-operative wound infections, primarily due to uro-genital microorganisms. Separate wards are recommended for head and neck surgery patients to reduce infection rates.
Area of Science:
- Infectious Diseases
- Surgical Outcomes
- Hospital Epidemiology
Background:
- Post-operative wound infections (PWIs) are a significant concern in surgical settings.
- Patient mixing across surgical subspecialties may influence PWI rates.
- Head and neck surgery (HNS) patients may be at risk from co-habitation with other surgical specialties.
Purpose of the Study:
- To evaluate the impact of mixing HNS patients with urology patients on PWI rates.
- To identify specific microorganisms contributing to changes in PWI.
- To provide evidence-based recommendations for patient management to reduce infection risk.
Main Methods:
- Retrospective analysis of PWI in HNS patients over two identical periods (March-November 2005 and 2006).
- Comparison of PWI rates before and after HNS patients were mixed with urology patients.
- Microbiological analysis of wound swabs, excluding Methicillin-resistant Staphylococcus aureus (MRSA).
Main Results:
- The overall rate of positive wound swabs increased from 4% in 2005 to 10% in 2006 (p = 0.024).
- Uro-genital microorganisms were identified as the primary factor driving the increase in PWI in 2006 (p = 0.008).
- Rates of MRSA remained statistically unchanged between the two periods (p = 0.464).
Conclusions:
- Mixing HNS patients with urology patients led to a significant rise in PWI.
- Uro-genital pathogens pose a heightened risk to HNS patients in mixed-ward settings.
- Management of HNS patients on separate wards is recommended to mitigate infection risks.
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