Risk control of surgical site infection after cardiothoracic surgery.
The purpose of this prospective study was to investigate whether a risk control programme based on risk assessment, new treatment modalities and the presence of a surveillance programme reduces the incidence of surgical site infections (SSI). Between January 2001 and December 2003, 167 patients were treated for a total of 183 SSIs. Data were collected on pre-operative risk factors, intra-operative data and postoperative recovery, including complications, infecting organisms, SSI treatment techniques and length of hospital stay. In this series, the total incidence of SSI was 5.6%. The mean age of affected patients was 65.1 years with a range of 20-87 years. Mean intensive care and hospital stay for SSI was 3.6 days and 18.8 days, respectively. Total mortality was 4.8%. Many risk factors were encountered, some of which were associated with a high morbidity. The majority of SSIs were treated by topical negative pressure therapy (N=81), which gave few side-effects and good clinical results. After starting the surveillance programme, a steady decline in prevalence was observed from 8.9% to 3.9%. This series adds to the evidence that SSI after cardiothoracic surgery is a major but mainly preventable cause of morbidity and mortality. Risk factor assessment, application of novel treatment modalities and an adequate surveillance system all increased patient safety.
Segers
P
P
Department of Cardiothoracic Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. p.segers@amc.uva.nl
de Jong
A P
AP
Kloek
J J
JJ
Spanjaard
L
L
de Mol
B A J M
BA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D019616:Thoracic Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data