Pearce P, McKenzie M, Taylor G
Infection Control Unit, University of Alberta Hospitals, Edmonton.
Can J Surg. 1991 Feb;34(1):31-5.
Substantial evidence now exists that ongoing surveillance of surgical wound infections can contribute to reduced infection rates. What is not yet determined is whether surveillance should be limited to the postoperative hospital stay or should be continued after patient discharge. To determine the number of infections occurring after discharge, the authors contacted a random sample of their patients who did not have wound infections during their hospitalization after orthopedic surgery. This was done 30 days after the procedure. The authors selected 273 patients of 1375 who underwent orthopedic surgery over a 7-month period and were able to contact 199 (73%). At the 30-day follow-up 23 patients (11.6%) had wound infections, as judged by wound discharge and physician prescription of antibiotics in 20 and the patient's description of pus issuing from the wound in 3. During the same period postoperative wound infections were found in only 19 (1.5%) of 1278 patients who were subjected to in-hospital surveillance. The authors conclude that, in patients who undergo orthopedic procedures, the majority of wound infections occur after discharge from the hospital and that infection rates based only on in-hospital surveillance greatly under represent true surgical wound infection rates for orthopedic procedures.
现在有大量证据表明，对外科手术伤口感染进行持续监测有助于降低感染率。尚未确定的是，监测是否应仅限于术后住院期间，还是应在患者出院后继续进行。为了确定出院后发生的感染数量，作者联系了他们在骨科手术后住院期间没有伤口感染的患者的随机样本。这是在手术后30天进行的。作者从1375名在7个月期间接受骨科手术的患者中选取了273名，能够联系到199名（73%）。在30天的随访中，23名患者（11.6%）发生了伤口感染，其中20名是根据伤口分泌物和医生开具的抗生素处方判断的，3名是根据患者描述伤口有脓液判断的。在同一时期，在接受院内监测的1278名患者中，仅发现19名（1.5%）术后伤口感染。作者得出结论，在接受骨科手术的患者中，大多数伤口感染发生在出院后，仅基于院内监测的感染率大大低估了骨科手术真正的手术伤口感染率。
