title: Surgical site infections in day surgery settings.
abstract: BACKGROUND
  Because major complications are rare in day surgery, minor morbidities such as surgical site infections, which become evident only after patient discharge, have a major impact on the perceived quality of care. We performed an audit of such infections over a oneyear period.
  
  
  METHODS
  All procedures were performed in a multidisciplinary day surgery setting. There were 155 inguinal hernia repairs, 44 excisions of lipomas, and 27 excisions of pilonidal cysts. All patients received antibiotic prophylaxis according to a rotation protocol.
  
  
  RESULTS
  One patient (0.65%) operated on for inguinal hernia developed a deep incisional infection caused by Staphylococcus schleiferi. The patient was treated using selective antibiotics, and complete recovery ensued. One patient (2.27%) who underwent excision of a lipoma revealed developed a deep incisional infection associated with fever (39 degrees C) caused by Staphylococcus aureus. He was treated by daily antibiotics and application of dressings for two weeks and recovered. One patient (3.7%) treated for pilonidal cyst developed a deep incisional surgical site infection. A group A Streptococcus was isolated, and he received an intravenous antibiotic for ten days. In the seven patients treated for pilonidal cyst with the wound left open, swab specimens were taken because of persisting local pain, and the following bacteria were found: Pseudomonas aeruginosa, Escherichia coli, Staphylococcus epidermidis, Proteus vulgaris, and Streptococcus constellatus. No antibiotic therapy was given, and local wound care led to complete recovery.
  
  
  CONCLUSIONS
  In our day surgery unit, the rates of surgical site infection are similar to those described in the literature. Continuing audit is essential to maintain and improve the quality and standard of the surgery provided. Prevention of surgical site infection is very much the responsibility of the persons working in the operating theater. Therefore, it is vital not only to apply strict regulations concerning everyday management but also to maintain a high degree of motivation among the personnel.
authors.affiliation: Department of Surgical Sciences, University of Insubria, Varese, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Brebbia
authors.forename: Luigi
authors.initials: L
authors.lastname: Boni
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.forename: Francesca
authors.initials: F
authors.lastname: Rovera
authors.forename: Mariacarla
authors.initials: M
authors.lastname: Besozzi
authors.forename: Mario
authors.initials: M
authors.lastname: Diurni
authors.forename: Giulio
authors.initials: G
authors.lastname: Carcano
authors.forename: Renzo
authors.initials: R
authors.lastname: Dionigi
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006095:Gram-Positive Cocci / Q000302:isolation & purification; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D008067:Lipoma / Q000601:surgery; D010864:Pilonidal Sinus / Q000601:surgery; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents