Wounds scrutiny in a Swedish hospital: prevalence, nursing care and bacteriology, including MRSA

Abstract

To identify all wounds, wound types and wound characteristics; to identify bacteria in all wounds, particularly MRSA, VRE and multi-resistant Gram-negative rods;. All patients admitted to or visiting hospital clinics were examined. If the patient had a wound, a questionnaire was filled in by a nurse, and if the wound met the inclusion criteria swabs were taken. A total of 2172 patients were admitted to or visited the hospital; 408 (19%) had a total of 668 wounds. Of this number, 248 were cultured. Thirty-seven patients had pressure ulcers, 83 had leg and foot ulcers and 288 patients had other types of wounds. Nursing care varied according to wound type and ward. Fifty-eight different types of wound dressings were used. Cleansing was performed with saline in 58% of the wounds. The mean number of dressing changes was once daily. Wounds were painful in 37% of the cases, with a predominance of leg and foot ulcers (51%). Many patients did not receive analgesia. MRSA was identified in two patients. No VRE was identified, and there was a low prevalence of multi-resistance in Enterobacteriaceae and Pseudomonas aeruginosa. The study provided important information for future improvement of wound care in a university hospital. Fewer resistant bacteria, particularly MRSA, were identified than expected.