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Effective and creative surveillance and reporting of surgical wound infections
Abstract:
Surgical wound infections offer a major challenge to hospital infection control programs. Surgical procedures and host factors are independent variables which markedly influence the risk of infection. Frequently used categories of surgical procedures (clean, contaminated, and infected) are inadequate to identify the special risks and problems of individual procedures. In 1976, in conjunction with the practicing surgeons of a large, referral hospital, the Infections Control Committee instituted surveillance of selected clean surgical procedures and deep-versus-superficial wound infections. Major problems associated with the cleaning of sternal saws and the timing of the administration of prophylactic antibiotics have been detected by these methods. Conventional surveillance undoubtedly would have overlooked these problems. Effective surveillance and control of surgical wound infections requires a willingness to modify surveillance activities to meet the local needs, and a determination to include the operating surgeons in the planning of surveillance activities.
Insights
Hospital infection control faces challenges from surgical wound infections. Tailored surveillance, involving surgeons, identifies issues like sternal saw cleaning and antibiotic timing missed by conventional methods.
Area of Science:
- Healthcare-associated infections
- Surgical site infection surveillance
- Hospital infection control
Background:
- Surgical wound infections pose a significant challenge to hospital infection control programs.
- Existing surgical procedure classifications (clean, contaminated, infected) are insufficient for identifying individual procedural risks.
- Host factors and surgical procedures are key independent variables influencing infection risk.
Purpose of the Study:
- To improve the identification and control of surgical wound infections.
- To address the limitations of conventional surveillance methods for surgical procedures.
- To develop a more effective surveillance system in collaboration with surgeons.
Main Methods:
- Instituted surveillance of selected clean surgical procedures in 1976.
- Differentiated between deep and superficial wound infections.
- Collaborated with practicing surgeons and the Infections Control Committee.
Main Results:
- Identified major problems with sternal saw cleaning protocols.
- Highlighted issues concerning the timing of prophylactic antibiotic administration.
- Demonstrated that conventional surveillance methods would have overlooked these specific problems.
Conclusions:
- Effective surveillance and control of surgical wound infections necessitate local adaptation of methods.
- Involving operating surgeons in the planning of surveillance activities is crucial for success.
- Modified surveillance approaches can uncover critical issues missed by standard practices.