Whitby M, McLaws M-L, Collopy B, Looke D F L, Doidge S, Henderson B, Selvey L, Gardner G, Stackelroth J, Sartor A
Infection Management Services, Princess Alexandra Hospital, Brisbane, Australia.
J Hosp Infect. 2002 Nov;52(3):155-60. doi: 10.1053/jhin.2002.1275.
Post-discharge surgical wound infection surveillance is an important part of many infection control programs. It is frequently undertaken by patient self-assessment, prompted either by a telephone or postal questionnaire. To assess the reliability of this method, 290 patients were followed for six weeks postoperatively. Their wounds were photographed and also covertly assessed for signs of infection by two experienced infection control nurses (ICNs). Patients also responded to a postal questionnaire seeking evidence of infection at both week four and week six post-surgery. Correlation between the patient's assessment of their wound and the ICNs diagnosis was poor (r = 0.37) with a low positive predictive value (28.7%), although negative predictive value was high (98.2%). Assessment of photos for signs of infection by two experienced clinicians also correlated poorly with the ICNs diagnosis of infection (r = 0.54). The patient's recall of prescription of an antibiotic by their general practitioner (GP) for wound infection during the postoperative period correlated best with the ICNs diagnosis (r = 0.76). This latter measure, particularly when confirmed by the GP in those patients reporting an infection, appears to provide the most valid and resource efficient marker of post-discharge surgical wound infection.
出院后手术伤口感染监测是许多感染控制项目的重要组成部分。它通常通过患者自我评估来进行，通过电话或邮寄问卷来促使患者进行评估。为了评估这种方法的可靠性，对290名患者进行了术后六周的随访。对他们的伤口进行了拍照，并由两名经验丰富的感染控制护士（ICN）对伤口感染迹象进行了秘密评估。患者还回复了一份邮寄问卷，以寻找术后第四周和第六周伤口感染的证据。患者对其伤口的评估与ICN的诊断之间的相关性较差（r = 0.37），阳性预测值较低（28.7%），尽管阴性预测值较高（98.2%）。两名经验丰富的临床医生对感染迹象照片的评估与ICN对感染的诊断相关性也较差（r = 0.54）。患者回忆其全科医生（GP）在术后期间因伤口感染开具抗生素的情况与ICN的诊断相关性最好（r = 0.76）。后一种测量方法，特别是当报告感染的患者得到GP证实时，似乎提供了出院后手术伤口感染最有效且资源高效的指标。
