The control of infection in general surgery: a four-year prospective study in Brazil

On January 1, 1977 a prospective study of the control of infection was initiated in the Division of General Surgery of the Federal University of Pernambuco and continues to the present day. The results of the first four years of this study are assessed in this paper. In the period from January 1, 1977 to December 31, 1980 1,636 patients were submitted to surgery, whose operations were classified as clean, clean-contaminated, contaminated and dirty. The number of infections was studied in relation to the type of operation. Other parameters studied included etiology, bacterial sensitivity, infection related to the six surgical groups functioning in the division and to the indication for elective or emergency surgery, respiratory infection, respiratory infection related to the anesthetist who administered the general anesthesia and wound infection in relation to the surgeon who performed the operation. The overall mortality was 2.64% and the percentage of necropsies carried out was 72%. Among the fatalities, sepsis was the predominant cause of death, accounting for 41% of the cases. The authors conclude that the control of infection is fundamental to the education of the medical and paramedical community and is to be regarded as a quality control of the service provided by the division of surgery. It should also be extended to the outpatient department and be accompanied by necropsy on the majority of the patients who fail to survive the operation.