Effectiveness of a surgical wound surveillance program.

A five-year surgical would surveillance program included the following features: (1) observations were made by a trained nurse-surveyor; (2) all surgical services, without exception, were surveyed; (3) the nurse-surveyor reported directly to the Chief, Surgical Service; (4) all infected wounds and all suspected of harboring an infection were observed daily by the nurse-surveyor; (5) all wounds were inspected on the third and seventh postoperative days, at hospital discharge, and at a follow-up clinic visit; and (6) cultures were obtained from all infected wounds. Data concerning infections for all surgical services were published each month at the mortality-morbidity conference. The number of wounds closed primarily and the number of infected wounds were recorded, together with calculations of wound infection rates by operation class, for each surgical service and for the whole hospital. During the study, the rate of wound infections progressively declined. The overall incidence decreased from 3.5% before the study began to less than 1% at its conclusion.