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Surgical wound infections: a 63-month survey in a developmental institution
1Michener Centre, Red Deer, Alta.
Abstract:
Michener Centre, a developmental institution of 1200 residents, instituted a nosocomial infection control program in October 1983, which included surgical wound monitoring. Of the 336 clean and clean-contaminated operations performed in the next 63 months, there were 15 wound infections attributable to the surgeon; another 7 occurred which were directly attributable to the patient's postoperative behaviour. Six of the seven occurred in severely retarded patients. The wound infection rate dropped during the surveillance period from 23% to 4.1% or less. Careful preselection of patients for elective surgery and studious attention to postoperative nursing care are necessary to achieve these rates or to reduce them further, particularly amongst severely retarded patients.
Insights
Implementing a nosocomial infection control program significantly reduced surgical wound infections at Michener Centre. Careful patient selection and postoperative nursing care are crucial for minimizing infection rates, especially in severely retarded patients.
Area of Science:
- Healthcare Management
- Infection Control
- Surgical Outcomes
Background:
- Michener Centre, a large developmental institution, faced challenges with nosocomial infections.
- A surgical wound monitoring component was integrated into the infection control program in October 1983.
Purpose of the Study:
- To evaluate the effectiveness of a nosocomial infection control program, specifically surgical wound monitoring.
- To identify factors contributing to surgical wound infections in a large institutionalized population.
Main Methods:
- Surveillance of 336 clean and clean-contaminated operations over 63 months.
- Tracking wound infections attributable to surgical staff and patient postoperative behavior.
- Monitoring infection rates before and after program implementation.
Main Results:
- The overall surgical wound infection rate decreased from 23% to 4.1% or less.
- Surgeon-attributable infections accounted for 15 cases; patient behavior contributed to 7 cases.
- Six of the seven patient-behavior-related infections occurred in severely retarded individuals.
Conclusions:
- The infection control program, including wound monitoring, was effective in reducing surgical site infections.
- Preoperative patient selection and diligent postoperative nursing care are essential for optimal outcomes.
- Special attention is required for severely retarded patients to further reduce infection risks.