[Implementation of a post-discharge surgical site infection system in herniorrhaphy and mastectomy procedures].
BACKGROUND
Monitoring surgical site infection (SSI) performed during hospitalization can underestimate its rates due to the shortening in hospital stay. The aim of this study was to determine the actual rates of SSI using a post-discharge monitoring system.


METHODS
All patients who underwent herniorraphy or mastectomy in the Hospital Universitario Ramón y Cajal from 1 January 2011 to 31 December 2011 were included. SSI data were collected prospectively according to the continuous quality improvement indicators (Indicadores Clinicos de Mejora Continua de la Calidad [INCLIMECC]) monitoring system. Post-discharge follow-up was conducted by telephone survey.


RESULTS
A total of 409patients were included in the study, of whom 299 underwent a herniorraphy procedure, and 110 underwent a mastectomy procedure. For herniorrhaphy, the SSI rate increased from 6.02% to 7.6% (the post-discharge survey detected 21.7% of SSI). For mastectomy, the SSI rate increased from 1.8% to 3.6% (the post-discharge survey detected 50% of SSI).


CONCLUSIONS
Post-discharge monitoring showed an increased detection of SSI incidence. Post-discharge monitoring is useful to analyze the real trend of SSI, and evaluate improvement actions. Post-discharge follow-up methods need to standardised.
Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: Isabel.sanz@salud.madrid.org.
Isabel
I
San Juan Sanz
Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España.
Cristina
C
Díaz-Agero-Pérez
Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España.
Ana
A
Robustillo-Rodela
Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España.
María José
MJ
Pita López
Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España.
Lourdes
L
Oliva Iñiguez
Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España.
Vicente
V
Monge-Jodrá
D005260:Female; D005500:Follow-Up Studies; D059685:Herniorrhaphy / Q000009:adverse effects*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008408:Mastectomy / Q000009:adverse effects*; D010351:Patient Discharge; D011446:Prospective Studies; D058996:Quality Improvement; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology*; D011795:Surveys and Questionnaires
Encuesta; INCLIMECC; Incidence; Incidencia; Infección de herida quirúrgica; Monitoring/follow-up; Post-discharge; Postalta; Surgical site infection; Vigilancia