Wound infection: the surgeon's responsibility

Area of Science:

• Surgical outcomes research
• Infection control in surgery

Background:

• Surgical audit is crucial for improving both efficiency and quality in clinical practice.
• In-house quality control is an essential component of surgical care.

Purpose of the Study:

• To prospectively determine the incidence of surgical wound infections.
• To describe the temporal pattern of infection presentation.
• To identify factors contributing to the development of surgical site infections.

Main Methods:

• Prospective study of 1,242 consecutive surgical patients (1,086 inpatients, 156 day cases).
• Data collection on infection incidence, presentation timing, and 23 etiological variables.
• Statistical analysis to identify significant associations with wound infection.

Main Results:

• Overall infection rate was 6.7% (79 inpatients, 4 day cases).
• Over 55% of infections presented within the first week, 89% within two weeks.
• Age, preoperative stay, shaving, and the surgeon were significantly associated with infection; surgeon association was particularly strong.

Conclusions:

• The surgeon is a significant factor in surgical wound infection development.
• Routine audit, supervision, junior staff training, and senior peer review are recommended.
• Findings have resource implications and highlight the need for quality improvement initiatives in surgical practice.