Surgical wound infections. A 5-year prospective study of 20,193 wounds at the Minneapolis VA Medical Center.

This report describes a 5-year prospective study of postoperative wound sepsis utilizing a careful program of wound surveillance. Surgical wounds following 20,193 operations on all surgical services were surveyed by a trained nurse epidemiologist. Daily examination of wounds, culture of all suspicious wounds, and 30-day outpatient clinic follow-up were performed. Results were disseminated at monthly intervals to all involved surgeons and operating room personnel. Prospective and ongoing analysis of results facilitated identification and rectification of specific problem areas. Wound infection rates demonstrated a steady decline over the course of the study, overall rates dropping from 4.2% to 1.9% (p less than 0.05). This reduction in incidence of postoperative wound sepsis of 55% is estimated to have saved 2740 inhospital days and nearly $750,000.