Reduction in wound infection rates by wound surveillance with postdischarge follow-up and feedback


Wilson, APR; Hodgson, B; Liu, M; Plummer, D; Taylor, I; Roberts, J; Jit, M; Sherlaw-Johnson, C; (2006) Reduction in wound infection rates by wound surveillance with postdischarge follow-up and feedback. The British journal of surgery, 93 (5). pp. 630-638. ISSN 0007-1323 DOI: 10.1002/bjs.5303

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Abstract

Background: Surgical wound surveillance with postdischarge follow-up is rarely done in the UK as it is seen as expensive. The aim of this study was to determine whether employing a dedicated team was effective and reduced costs. Methods., Infection data were collected prospectively with postdischarge follow-up at 2-3 months, and fed back to surgeons. Wound infection was defined using both ASEPSIS wound scoring and criteria of the US Centers for Disease Control (CDC) definitions. Results: Over 4 years, 15 548 patient episodes were included. Postdischarge surveillance data were available for 79.9 percent of the 15 154 records of patients who survived. There was a significant reduction in the rate of wound infection between the first and fourth years by ASEPSIS and CDC definitions: odds ratio 0.77 (95 per cent confidence interval (c.i.) 0.64 to 0.92) and 0.69 (95 per cent c.i. 0.57 to 0.83), respectively. The proportion of infections fell significantly in orthopaedic, cardiac and thoracic surgery. The annual budget for wound surveillance was 91600 pound. Changes in infection rates contributed 347491 pound to the reduction in cost among the patients surveyed. Conclusion: Wound surveillance was associated with a reduction in rates of wound infection within 4 years. The cost reduction as a result of fewer infections exceeded the cost of surveillance after 2 years.

Item Type: Article
Keywords: Surgical site infection, scoring method, nosocomial infections, united-states, definitions, asepsis, system, Cost-Benefit Analysis, Feedback, Humans, Infection Control, economics, methods, Length of Stay, Patient Care Team, Patient Discharge, Postoperative Care, economics, methods, Prospective Studies, Regression Analysis, Research Support, Non-U.S. Gov't, Surgical Wound Infection, economics, prevention & control
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 16550635
Web of Science ID: 237745200020
URI: http://researchonline.lshtm.ac.uk/id/eprint/11857

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