Chapter 11 - Surgical Wound Infection

Abstract

OBJECTIVE: To review the risk factors for surgical wound infection; the use of prophylactic antibiotics in the prevention of wound infection; and the benefits of wound surveillance programmes to reduce the rate of surgical wound infection. DATA SOURCES: Medline literature search and review of published work on surgical wound infection, and the references cited in them. STUDY SELECTION: Critical studies containing supporting evidence were selected. DATA EXTRACTION: Data were extracted independently by multiple observers. DATA SYNTHESIS: Factors that affect the susceptibility of a wound to infection include a pre-existing illness, the duration of the operative procedure, wound contamination, three or more diagnoses at the time of discharge, and abdominal operations. Antibiotic prophylaxis can decrease postoperative morbidity, shorten hospital stay, and reduce overall costs attributable to infection; the choice of antibiotic depends on the wound class. Wound surveillance can also decrease wound infection rates. CONCLUSION: Surgical wound infections are common and consume a considerable portion of health care finances. A reduction in the infection rate to a minimal level, however, can be achieved by the judicious use of antibiotic prophylaxis and the use of an organised system of wound surveillance and reporting.