The use of the wound scoring method ‘ASEPSIS’ in postoperative wound surveillance

Abstract

For the purposes of wound surveillance programmes and clinical trials, a wound scoring method, ASEPSIS, makes assessment of wound sepsis more objective and reproducible by allotting points both for the appearance of the wound in the first week and for the clinical consequences of infection. ASEPSIS was compared with other definitions of wound infection in 1029 surgical patients and its suitability for surveillance and detection of risk factors were examined. Satisfactory healing was recorded in 867 patients, disturbance of healing in 74 and minor, moderate and severe wound infection in 41, 24 and 23 patients respectively. An ASEPSIS score over 20 points was more sensitive and as specific as the presence of pus as an indicator of changes in management resulting from infection. Multiple regression analysis of ASEPSIS scores indicated that operation type, ward, degree of contamination, age, body mass index, and preoperative stay in hospital were significant risk factors. In matching 52 infected patients with uninfected controls, any wound score over 10 points was associated with a significant delay in discharge from hospital (median 3 days, P < 0·0005).