Wounds scrutiny in a Swedish hospital: prevalence, nursing care and bacteriology, including MRSA.
OBJECTIVE
To identify all wounds, wound types and wound characteristics; to identify bacteria in all wounds, particularly MRSA, VRE and multi-resistant Gram-negative rods;.


METHODS
All patients admitted to or visiting hospital clinics were examined. If the patient had a wound, a questionnaire was filled in by a nurse, and if the wound met the inclusion criteria swabs were taken.


RESULTS
A total of 2172 patients were admitted to or visited the hospital; 408 (19%) had a total of 668 wounds. Of this number, 248 were cultured. Thirty-seven patients had pressure ulcers, 83 had leg and foot ulcers and 288 patients had other types of wounds. Nursing care varied according to wound type and ward. Fifty-eight different types of wound dressings were used. Cleansing was performed with saline in 58% of the wounds. The mean number of dressing changes was once daily. Wounds were painful in 37% of the cases, with a predominance of leg and foot ulcers (51%). Many patients did not receive analgesia. MRSA was identified in two patients. No VRE was identified, and there was a low prevalence of multi-resistance in Enterobacteriaceae and Pseudomonas aeruginosa.


CONCLUSIONS
The study provided important information for future improvement of wound care in a university hospital. Fewer resistant bacteria, particularly MRSA, were identified than expected.
Lindholm
C
C
Department of Surgery, Karolinska Institute, Kristianstad University, Sweden. christina.lindholm@hv.hkr.se
Andersson
H
H
Fossum
B
B
Jörbeck
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000451:nursing; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000451:nursing; D024881:Drug Resistance, Bacterial; D005260:Female; D006301:Health Services Needs and Demand; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015403:Nursing Evaluation Research; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D017592:Skin Care / Q000379:methods / Q000451:nursing / Q000592:standards; D013548:Sweden / Q000453:epidemiology; D017749:Total Quality Management; D014946:Wound Infection / Q000453:epidemiology / Q000382:microbiology / Q000451:nursing