Infection registration underestimates the risk of surgical wound infections

Two consecutive bedside prevalence studies of 455 surgical patients were made by the same infection control nurse in 15 surgical and gynaecological departments in eight Danish hospitals. There was a high degree of diagnostic agreement between the prevalence survey and the clinical data. Four point six percent had a deep, and another 4.6%, a superficial surgical wound infection (SWI). Two months after the second survey only one third of these patients had their infection correctly recorded by the routine hospital surveillance of SWI. Better routines need to be developed to secure a valid, reliable and simple registration of relevant infectious wound complications. A follow-up was carried out with self-administered questionnaires in 2976 patients, of whom 1447 (48.6%) responded. This post-discharge survey showed that 15.7% had been treated with antibiotics, because of pus in the wound, 12.4% had to have the wound reopened and 6.6% experienced both these treatments.