Surveillance of surgical wound infections following open heart surgery.
OBJECTIVE
To define accurate wound infection rates for the cardiac surgery service based on site of infection and characterization as "deep" or "incisional" and to determine whether a correctable cause for an apparent increase in deep wound infection rates existed.


METHODS
Observational.


METHODS
Tertiary-care teaching hospital.


METHODS
All adults undergoing open heart surgery in 1988 and 1989.


METHODS
Changed from razor to clipper preoperative hair removal in January 1989.


RESULTS
Deep sternotomy wound infections decreased significantly from 1.2% in 1988 to 0.2% in 1989 (p = .010) and deep venectomy (vein donor site) wound infections declined from 1.6% to 0.4% (p = .014) during the same time period. Incisional wound infection rates did not change. Patients with deep infections more likely required readmission or operation to treat their infection than those with incisional wound infections. The percentage of gram-negative organisms causing wound infections decreased from 56.3% in 1988 to 34.7% in 1989 (p = .017).


CONCLUSIONS
Preoperative hair removal using a clipper appears to have decreased the risk of deep wound infection compared with razor preparation. The dichotomous wound classification of "deep" and "incisional" distinguished between patients who required additional interventions for treatment of wound infections.
Sellick
J A
JA
Division of Infectious Diseases, State University of New York, Buffalo.
Stelmach
M
M
Mylotte
J M
JM
D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data*; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D006204:Hair Removal / Q000379:methods; D006746:Hospital Bed Capacity, 500 and over; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D009518:New York / Q000453:epidemiology; D011159:Population Surveillance; D011300:Preoperative Care; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000145:classification / Q000453:epidemiology* / Q000517:prevention & control