Wound infection in total joint arthroplasty: effect of extended wound surveillance on wound infection rates.
OBJECTIVE
To determine the effects of a wound monitoring program on infection rates after total joint arthroplasty.


METHODS
Case series, comparing postoperative wound infection rates before and after hospital discharge.


METHODS
A university-affiliated tertiary-care hospital.


METHODS
A group of 865 patients who underwent primary or revision total hip or knee arthroplasty between September 1989 and September 1991 followed by in-hospital and post-discharge wound monitoring was compared with a baseline group of 204 patients who had undergone an arthroplasty procedure and in-hospital wound monitoring between March and September 1988; only 38 of these patients were selected for post-discharge monitoring.


METHODS
In the study group, wounds were monitored every 48 to 72 hours to the time of patient discharge and at 30 days post-discharge. Monthly reports of surgeon-specific and overall infection rates were sent to each surgeon during both baseline and study periods.


METHODS
Presence or absence of surgical wound infection.


RESULTS
The initial overall wound infection rate was 9.9%. This decreased to 3.8% in the study group, after the wound monitoring program had been in place for at least 18 months. Post-discharge monitoring accounted for the majority of wound infections diagnosed.


CONCLUSIONS
A wound monitoring program may be an important tool in lowering wound infection rates associated with total joint arthroplasty. Post-discharge monitoring is important in determining true wound infection rates.
Taylor
S
S
Department of Surgery, University of Alberta Hospitals, Edmonton.
Pearce
P
P
McKenzie
M
M
Taylor
G D
GD
D000416:Alberta / Q000453:epidemiology; D005500:Follow-Up Studies; D013502:General Surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D010351:Patient Discharge; D011159:Population Surveillance; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control