Garcia Stickney Danielle N, Thieman Mankin Kelley M
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, Texas.
Vet Surg. 2018 Jan;47(1):66-73. doi: 10.1111/vsu.12738. Epub 2017 Nov 2.
To evaluate the impact of postdischarge surveillance on surgical site infection (SSI) diagnosis.
Prospective enrollment with retrospective case review SAMPLE POPULATION: Dogs and cats (n = 1271) undergoing surgery April 2012-November 2013.
The medical record of each animal was reviewed and a 30-day follow-up questionnaire was sent to each pet owner. A standardized definition of SSI was used to identify all animals with SSI. The method of SSI detection was recorded as: re-presentation to the hospital, scheduled recheck, questionnaire, communication with the referring veterinarian, or a combination of the above.
SSI was identified in 36 (2.83%) of the 1271 animals included. All SSIs were diagnosed after discharge from the hospital. Seven of the 36 animals with SSI were diagnosed at re-presentation to the hospital, 5/36 at scheduled recheck, 10/36 on questionnaire, 10/36 at re-presentation to the hospital AND on questionnaire, and 4/36 on communication with referring veterinarian. Of the diagnosed SSIs, 72.2% were documented in the medical record. Therefore, without active postdischarge surveillance, 10/36 SSIs (27.8%) would have gone unknown to surgeons at our institution.
Understanding the incidence of SSI with feedback to surgeons is an important aspect of an infection control program and has been shown to reduce SSI risks. Without active postoperative surveillance, 27.8% of SSIs would have gone unknown to surgeons. Implementing active surveillance will allow accurate reporting of incidence of SSIs in veterinary hospitals.
评估出院后监测对外科手术部位感染(SSI)诊断的影响。
前瞻性纳入并进行回顾性病例审查
2012年4月至2013年11月接受手术的犬猫(n = 1271)。
查阅每只动物的病历,并向每位宠物主人发送一份30天的随访问卷。采用SSI的标准化定义来识别所有患有SSI的动物。记录SSI的检测方法为:再次到医院就诊、定期复查、问卷调查、与转诊兽医沟通或上述方法的组合。
在纳入的1271只动物中,有36只(2.83%)被诊断为SSI。所有SSI均在出院后被诊断出来。36只患有SSI的动物中,7只在再次到医院就诊时被诊断出来,5/36在定期复查时被诊断出来,10/36通过问卷调查被诊断出来,10/36在再次到医院就诊且通过问卷调查被诊断出来,4/36通过与转诊兽医沟通被诊断出来。在诊断出的SSI中,72.2%记录在病历中。因此,如果没有积极的出院后监测,我们机构的外科医生将有10/36(27.8%)的SSI病例无从知晓。
了解SSI的发生率并向外科医生反馈是感染控制计划的一个重要方面,并且已被证明可以降低SSI风险。如果没有积极的术后监测,27.8%的SSI病例外科医生将无从知晓。实施积极监测将有助于准确报告兽医医院中SSI的发生率。