Fanning C, Johnston B L, MacDonald S, LeFort-Jost S, Dockerty E
Can J Infect Control. 1995 Autumn;10(3):75-9.
To evaluate three methods for conducting post-discharge surgical site infection (SSI) surveillance.
Patients undergoing in-patient and day-patient surgery were prospectively randomized to one of three surveillance methods: group 1, patient questionnaire (mailed back); group 2, surgeon follow-up card; or group 3, patient questionnaire (telephoned by an infection control practitioner [ICP]). There were 200 in-patients and 200 day-patients randomized to each group. Evaluation of SSI was conducted 30 days postoperatively.
A 760-bed tertiary care teaching hospital.
Questionnaires were sent home with 350 patients. Fifteen in-patients and 35 day-patients were excluded; 15 in-patients and 17 day-patients returned questionnaires early (fewer than three weeks postoperation), leaving 54 of 185 in-patients (29.2%) and 25 of 165 day-patients (15.2%) with timely returns. Seven (three in-patients and four day-patients) reported symptoms of SSI. Surgeons received cards for 400 patients; cards were returned for 118 of 203 in-patients (58.1%) and 142 of 197 day-patients (72.1%). Twelve (seven in-patients and five day-patients) were reported to have developed SSI. ICPS telephoned 332 patients; 187 of 196 in-patients (95.4%) and 107 of 126 day-patients (84.9%) were reached in six or fewer attempts. Four in-patients and 74 day-patients were lost due to cancellation of surgery or no surgical incision. Fourteen (10 in-patients and four day-patients) reported symptoms of SSI. For group 1 patients, ICPS spent 17 h distributing questionnaires and instructing staff; for group 2, ICPs spent no time distributing material; and for group 3, ICPS spent at least 8 h completing data forms, 16.5 h on the telephone and 33 h conducting demographic data retrieval from the hospital computer.
In this setting, surgeon follow-up cards were the most efficient and reliable method for conducting postdischarge SSI surveillance. They provided a good rate of return and were time efficient, and wound evaluation was done by trained professionals using standard criteria for diagnosis of postoperative SSI.
评估三种出院后手术部位感染（SSI）监测方法。
对住院和日间手术患者进行前瞻性随机分组，分为三种监测方法之一：第1组，患者问卷调查（邮寄回）；第2组，外科医生随访卡；第3组，患者问卷调查（由感染控制从业者[ICP]电话随访）。每组随机分配200名住院患者和200名日间手术患者。术后30天进行SSI评估。
一家拥有760张床位的三级护理教学医院。
向350名患者发放了问卷。15名住院患者和35名日间手术患者被排除；15名住院患者和17名日间手术患者提前返回问卷（术后少于三周），185名住院患者中有54名（29.2%）、165名日间手术患者中有25名（15.2%）及时返回问卷。7名（3名住院患者和4名日间手术患者）报告有SSI症状。外科医生收到了400名患者的卡片；203名住院患者中有118名（58.1%）、197名日间手术患者中有142名（72.1%）返回了卡片。报告有12名（7名住院患者和5名日间手术患者）发生了SSI。ICP对332名患者进行了电话随访；196名住院患者中有187名（95.4%）、126名日间手术患者中有107名（84.9%）在6次或更少尝试中联系上。4名住院患者和74名日间手术患者因手术取消或无手术切口而失访。14名（10名住院患者和4名日间手术患者）报告有SSI症状。对于第1组患者，ICP花费17小时分发问卷并指导工作人员；对于第2组，ICP未花费时间分发材料；对于第3组，ICP至少花费8小时填写数据表格、16.5小时打电话以及33小时从医院计算机检索人口统计学数据。
在这种情况下，外科医生随访卡是出院后SSI监测最有效、最可靠的方法。它们回收率高且省时，伤口评估由经过培训的专业人员使用术后SSI诊断标准进行。
