The necessity and efficiency of wound surveillance after discharge
J. A. Weigelt, D. Dryer and R. W. Haley
Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75235-9031.
A surgical wound surveillance program followed up 16,453 consecutive
patients from 1983 through 1988. Patients were followed up for 30 days
after operation, and 516 (35%) of the surgical wound infections first
became manifest after discharge. In-hospital surveillance alone would have
estimated the surgical wound infection rate to be 5.8% when the true rate
was 8.9%. Infections that occurred after discharge were more likely in
clean operations, in shorter operations, in obese patients, and in
nonalcoholic patients. The probability that infections would begin after
discharge was inversely associated with the duration of postoperative stay
in the hospital. Postdischarge follow-up of patients who previously have
undergone surgery is necessary to avoid underestimated of the infection
rates and biases related to known risk factors. The most efficient time to
survey patients appears to be at 21 days after the operation, at which time
90% of surgical wound infections have occurred.
