Continuous, 10-year wound infection surveillance. Results, advantages, and unanswered questions
M. M. Olson and J. T. Lee Jr
Surgical Service, Veterans Administration Medical Center, Mineapolis, Minn. 55417.
During a 10-year wound infection surveillance program, 1032 wound
infections complicated 40,915 operations. Surveillance continued for 30
days postoperatively, and rigid clinical criteria for diagnosis were
honored. Operations were distributed unequally among infection risk
classes: clean (class I), 63.3%; clean contaminated (class II), 26.4%; and
contaminated (class III), 10.3%. Infections occurred with nearly equal
frequencies among classes: I, 36.1%; II, 29.5%; and III, 34.4%. Wound
infection rates during the 10-year period were 2.5% (all operations), 1.4%
(class I), 2.8% (class II), and 8.4% (class III). Index year (1977)
infection rates were 4.2% (all operations), 2.3% (class I), 5.4% (class
II), and 12.8% (class III). Wound infection rates during the last 9 years
of surveillance in every risk class were significantly less than index year
rates, representing infection rate decreases of 38% to 56%. Estimated
savings in hospital room costs alone reached $3 million during 10 years.
