Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-06-05T19:34:50.973Z Has data issue: false hasContentIssue false
  • English
  • Français

Consensus Paper on the Surveillance of Surgical Wound Infections

Published online by Cambridge University Press:  21 June 2016

The Society for Hospital Epidemiology of America ,
Association for Practitioners in Infection Control ,
Centers for Disease Control  and
Surgical Infection Society
Get access Rights & Permissions [Opens in a new window]

Abstract

A Surgical Wound Infection (SWI) Task Force was convened by The Society for Hospital Epidemiology of America (SHEA) to evaluate how SWI surveillance should be done and to identify where more information is needed. The Task Force reached consensus in the following areas. The Centers for Disease Control (CDC) definitions of SWI should be used for routine surveillance because of their current widespread acceptance and reproducibility. The CDC definitions have been clarified in an accompanying article (“Report From the CDC”). Direct observation of wounds and traditional infection control surveillance techniques are acceptable methods of case finding for hospitalized patients. The optimal method for case finding postdischarge or after outpatient surgery is unknown at this time. SWI rates should be stratified by surgical wound class plus a measure of patient susceptibility to infection, such as the American Society of Anesthesiology (ASA) class, and duration of surgery Surgeon-specific SWI rates should be calculated and reported to individual surgeons.

Type
SHEA, APIC, CDC, SIS Consensus Paper
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 10 , October 1992 , pp. 599 - 605
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Langmuir, AD. The surveillance of communicable diseases of national importance. N Engl J Med. 1963;268:182–192.CrossRefGoogle ScholarPubMed
2. Brachman, PS. Surveillance of institutionally acquired infections. In: Proceedings of the National Conference on Institutionally Acquired Infections, Minneapolis, Univenity of Minnesota School of Public Health, September 4-6. Washington, DC: U.S. Government Printing Office; 1964:138–147. PHS publication 1188.Google Scholar
3. Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in U.S. hospitals. Am J Epidemiol. 1985;121:182–205.10.1093/oxfordjournals.aje.a113990CrossRefGoogle Scholar
4. Cruse, PJE, Foord, R. The epidemiology of wound infection: a 10-year prospective study of 62,939 wounds. Surg Clin North Am. 1980;60:27–40.10.1016/S0039-6109(16)42031-1CrossRefGoogle Scholar
5. Condon, RE, Schulte, WJ, Malangoni, MA, et al. Effectiveness of a surgical wound surveillance program. Arch Surg. 1983; 118:303–307.CrossRefGoogle ScholarPubMed
6. Olson, MM, Lee, JT Jr. Continuous, 10-year wound infection surveillance: results, advantages and unanswered questions. Arch Surg. 1990;125:794–803.10.1001/archsurg.1990.01410180120020CrossRefGoogle ScholarPubMed
7. Condon, RE. Haley, RW, Lee, JT Jr., et al. Does infection control control infection? Arch Surg. 1988;123:250–256.CrossRefGoogle ScholarPubMed
8. Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington, DC: U.S. Dept. of Health and Human Services; 1991.Google Scholar
9. Garner, JS, Jarvis, WR, Emori, TG, et al. CDC definitions for nosocomial infections., 1988. Am J Infect Control. 1988;16:128–140.CrossRefGoogle ScholarPubMed
10. Larson, E, Horan, T, Kotilainen, H, et al. APIC Research Committee, 19881989. Study of the definitions of nosocomial infections. Am /Infect Control. In press.Google Scholar
11. Horan, TC, Gaynes, RP, Martone, WJ, Jarvis, WR, Emori, TG. CDC definitions for nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992;13:606–608.CrossRefGoogle ScholarPubMed
12. Mead, PB, Pories, SE, Hall, P, et al. Decreasing the incidence of surgical wound infections. Validation of a surveillance-notification program. Arch Surg. 1986;121:458–461.CrossRefGoogle ScholarPubMed
13. Kerstein, M, Flower, M, Harkavy, LM, et al. Surveillance for postoperative wounds infections: practical aspects. Am Surg. 1978;44:210–214.Google ScholarPubMed
14. Wenzel, RP, Osterman, CA, Hunting, KJ, et al. Hospital-acquired infections, I: surveillance in a university hospital. Am J Epidemiol. 1976;103:251–260.10.1093/oxfordjournals.aje.a112223CrossRefGoogle ScholarPubMed
15. Haley, RW, Culver, DH, Morgan, WM, et al. Identifying patients at high risk of surgical wound infection: a simple multivariate index of patient susceptibility and wound contamination. Am J Epidemiol. 1985;121:206–215.10.1093/oxfordjournals.aje.a113991CrossRefGoogle ScholarPubMed
16. Gil-Egea, MJ, Pi-Sunyer, MT, Verdaguer, A, et al. Surgical wound infections: prospective study of 4,468 clean wounds. Infect Control. 1987;8:277–280.CrossRefGoogle ScholarPubMed
17. Burns, JJ, Dippe, SE. Postoperative wound infections detected during hospitalization and after discharge in a community hospital. Am J Infect Control. 1982;10:60–64.10.1016/0196-6553(82)90004-9CrossRefGoogle Scholar
18. Collier, C, Miller, DP, Borst, M. Community hospital surgeon-specific infection rates. Infect Control. 1987;8:249–254.CrossRefGoogle ScholarPubMed
19. Thompson, RL. Surveillance and reporting of nosocomial infections. In: Wenzel, RR ed. Prevention and Control of Nosocomial Infections. Baltimore; Md: Williams &Wilkins; 1987:70–82.Google Scholar
20. Froggatt, JW, Mayhall, CG. Development and validation of a surveillance system for postoperative wound infections in a university center. Presented at the 89th Annual Meeting of the American Society for Microbiology; May 14-18, 1989; New Orleans, La.Google Scholar
21. Weigelt, JA, Dryer, D, Haley, RW. Necessity and efficiency of wound surveillance after discharge. Presented at the Third Decennial International Conference on Nosocomial Infections; My 31-August 3, 1990; Altanta, Ga.Google Scholar
22. Polk, BE, Tager, EB, Shapiro, M, et al. Randomized clinical trial of perioperative cefazolin in preventing infection after hysterectomy. Lancet. 1980;i:437–441.CrossRefGoogle Scholar
23. Donovan, IA, Ellis, D, Gatehouse, D, et al. One-dose antibiotic prophylaxis against wound infection after appendectomy: a randomized trial of clindamycin, cefazolin sodium and a placebo. Br J Surg. 1979;66:192–196.Google ScholarPubMed
24. Brown, RB, Bradley, S, Opitz, E, et al. Surgical wound infections documented after hospital discharge. Am J Infect Control. 1987;15:54–58.CrossRefGoogle ScholarPubMed
25. Bates, T, Touquet, VLR, Tutton, MD, et al. Prophylactic metronidazole in appendectomy: a controlled trial. Br J Surg. 1980;67:547–550.CrossRefGoogle ScholarPubMed
26. Salem, RJ, Johnson, J, Devitt, I? Short term metronidazole therapy contrasted with povidoneiodine spray in the prevention of wound infection after appendectomy. Br J Surg. 1979;66:430–431.CrossRefGoogle Scholar
27. Seaman, M, Lammers, R. Inability of patients to self-diagnose wound infections . J Emerg Med. 1991;9:215–219.CrossRefGoogle ScholarPubMed
28. Jones, JM, Matherlee, M. Medicare's prudent approach to paying for ambulatory surgery services. Journal for Ambulatory Care Management. 1990;13:25–32.CrossRefGoogle ScholarPubMed
29. Goodman, RA, Solomon, SL. Transmission of infectious diseases in outpatient health care settings. JAMA. 1991;265:2377–2381.10.1001/jama.1991.03460180083038CrossRefGoogle ScholarPubMed
30. Craig, CP. Infection surveillance for ambulatory surgery patients: an overview. Quarterly Review Board. 1983;107–111.Google ScholarPubMed
31. Natof, EE. Complications associated with ambulatory surgery. JAMA. 1980;244:1116–1118.CrossRefGoogle ScholarPubMed
32. Flanders, E, Mnnant, JR. Ambulatory surgery postoperative wound surveillance. Am J Infect Control. 1990;18:336–339.CrossRefGoogle ScholarPubMed
33. Joint Comission on Accreditation of Healthcare Organizations. Accreditation Manual for Hospitals. Chicago, Ill: Joint Commission on Accreditation of Healthcare Organizations; 1991.Google Scholar
34. Ad Hoc Committee on Trauma, Division of Medical Sciences, National Academy of Sciences-National Research Council. Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and of various other factors. Ann Surg. 1964;160(suppl):1–192.Google Scholar
35. Cruse, P. Infection surveillance: Identifying the problems and the high-risk oatient. South Med 1 1977;70:4–8.CrossRefGoogle Scholar
36. Cruse, I? Wound infection surveillance. Rev Infect Dis. 1981;3:734–737.CrossRefGoogle ScholarPubMed
37. Davidson, AIG, Clark, C, Smith, G. Postoperative wound infection: a computer analysis. Br J Surg. 1971;58:333–337.CrossRefGoogle ScholarPubMed
38. Shapiro, M, Munoz, A, Tager, IB, et al. Risk factors for infection at the operative site after abdominal or vaginal hysterectomy, N Engl J Med. 1982;307:1661–1666.CrossRefGoogle ScholarPubMed
39. NagachintaT, Stephens M T, Stephens M, Reitz, B, et al. Risk factors for surgical-wound infection following cardiac surgery. J Infect Dis. 1987;156:967–973.CrossRefGoogle ScholarPubMed
40. Britt, MR, Schleupner, CJ, Matsumiya, S. Severity of underlying disease as a predictor of nosocomial infection: utility in the control of nosocomial infection. JAMA. 1978;239:1047–1051.CrossRefGoogle ScholarPubMed
41. Hooton, TM, Haley, RW, Culver, DH, et al. The joint associations of multiple risk factors with the occurrence of nosocomial infection. Am JMed. 1981;70:960–970.Google ScholarPubMed
42. Owens, WD, Felts, JA, Spitznagel, EL. ASA physical status classifications: a study of consistency of ratings. Anesthesiology 1978;49:239–243.CrossRefGoogle ScholarPubMed
43. Culver, DH, Horan, TC, Gaynes, RP, et al. Surgical wound infection rates by wound class, operative procedure and patient risk index. Am J Med. 1991;91(3B):152S–157S.CrossRefGoogle ScholarPubMed
44. Garibaldi, RA, Cushing, D, Lerer, T. Risk factors for postoperative infection. Am J Med. 1991:91(3B):158S–163S.CrossRefGoogle ScholarPubMed
45. Alexander, JW, Fischer, JE, Boyajian, M, et al. The influence of hair-removal methods on wound infections. Arch Surg. 1983;118:347–352.CrossRefGoogle ScholarPubMed
46. Bibby, BA, Collins, BJ, Ayliie, GAJ. A mathematical model for assessing risk of postoperative wound infection. J Hosp Infect. 1986;8:31–39.CrossRefGoogle ScholarPubMed
47. Altemeier, WA, Burke, JF, Pruitt, BA, et al. American College of Surgeons Manual on Control of Infections in Surgical Patients. 2nd ed. Philadelphia, Pa: J.B. Lippincott Co.; 1984.Google Scholar
48. Simmons, BP CDC guidelines on infection control. Infect Control. 1982;3:187–196.CrossRefGoogle ScholarPubMed
49. Pollock, AV, Evans, M, Parida, S. The prediction of abdominal surgical wound infection: the value of an enrichment broth for initial culture of operative parietal swabs. J Hosp Infect. 1986;8:242–247.CrossRefGoogle ScholarPubMed
50. Claesson, BEB, Holmlund, DEW. Predictors of intraoperative bacterial contamination and postoperative infection in elective colorectal surgery. J Hosp Infect. 1988;11:127–135.CrossRefGoogle ScholarPubMed
51. Ehrenkranz, NJ. Surgical wound infection occurrence in clean operations: risk stratification for interhospital comparisons. Am J Med. 1981;70:909–914.10.1016/0002-9343(81)90554-4CrossRefGoogle ScholarPubMed
52. Scheckler, WE. Surgeon-specific wound infection rates-a potentially dangerous and misleading strategy. Infect Control Hosp Epidemiol. 1988;9:145–146.Google ScholarPubMed
53. Penin, GB, Ehrenkranz, NJ. Priorities for surveillance and cost-effective control of postoperative infection. Arch Surg. 1988;123:1305–1308.CrossRefGoogle ScholarPubMed
54. Centers for Disease Control. Nosocomial infection rates for interhospital comparison: limitations and possible solutions. Infect Control Hosp Epidemiol. 1991;12:609–621.10.1086/646250CrossRefGoogle Scholar