Risk Of Postoperative Wound Infection Research Articles

A mathematical model for assessing risk of postoperative wound infection

A mathematical model for predicting the risk of acquisition of postoperative wound infection in individuals or groups of patients is described. It is based on data from prevalence surveys of 41 hospitals and includes 1980 wounds. The factors included in the model i.e., age, sex, length of pre-operative stay, type of operation, wound drainage, number of occupied beds in ward, and special factors e.g., diabetes, steroid therapy, were obtained by stepwise regression analysis of the original data. Most of the ward facilities and practices were excluded as non-significant. The model has been modified for use with incidence studies and its accuracy confirmed in a further 1331 patients by comparing predicted and recorded infection rates.

Wide variation in risk of wound infection following clean neurosurgery. Implications for perioperative antibiotic prophylaxis.

The authors have prospectively examined the occurrence of postoperative wound infection following clean neurosurgery in 936 patients. Fewer than 1% received perioperative antibiotic prophylaxis. The overall rate of deep wound infection was 2.6%; no deaths were directly attributable to these infections. Deep wound infections occurred significantly more frequently following craniotomy (4.3%) than following spinal (0.9%) or other clean neurosurgery. Among craniotomies, the deep wound infection rate varied significantly from 11% following repeat operations for recurrent gliomas to 2.5% following non-tumor surgery. Risk of deep wound infection varied more than 11-fold depending on the type of clean neurosurgical operation. It is most feasible to demonstrate the potential efficacy of perioperative antibiotics in clean neurosurgical procedures with the greatest risk of postoperative wound infection. The potential benefit from such prophylaxis would be greatest for patients undergoing these high-risk operations.

Multivariate analysis of determinants of postoperative wound infection in orthopaedic patients

In a prospective study of 376 orthopaedic patients, the relative contribution of host factors and patient-care variables to the risk of postoperative wound infection was evaluated. Host factors studied were age, sex, ethnic origin and diagnosis. The number of operations, the insertion of an open drain, the use of prophylactic antibiotics and the length of the operation were the patient-care variables studied. Of the risk factors identified, the performance of more than one operation during an admission had the highest risk coefficient, followed by the presence of an open drain, internal fixation of a fracture, and spine fusion. Within the group of operations for internal fixation, those for fractures of the femur had the highest risk of infection. In spine fusions those operations lasting 5 or more hours were associated with a high risk of infection. The length of stay of infected patients was on average 17·9 days longer than that of their individually-matched non-infected controls.

Risk Factors for Post-operative Wound Infection in Cardiac Surgery Patients

In a prospective study of 372 patients undergoing cardiac surgery, we evaluated the relative contribution of host factors and patient care variables to the risk of post-operative wound infection. Host factors studied were age, sex, country of origin, the diagnosis for which the operation was performed and, for coronary artery by-pass operations, the functional cardiac status according to modified New York Heart Association criteria. The performance of more than one operation during a single admission carried the highest risk for infection, followed by a coronary artery by-pass operation lasting for more than six hours or performed on patients 65 years or older. In patients undergoing coronary artery by-pass surgery, host factors (age and cardiac function) were associated with infections in the chest wound, while the length of the operation was found to affect the occurrence of infections at the "donor" site.

Wound infections after preoperative depilatory versus razor preparation

Abstract The influence of the method of hair removal, razor versus depilatory, on the risk of postoperative wound infection was studied in 406 cases. The infection rate was 5.6 per cent after razor preparation, 0.6 per cent after depilatory, and 0.6 per cent after no preparation. After razor preparation, the infection rate was 3.1 per cent when done just prior to surgery, 7.1 per cent when done up to twenty-four hours prior to surgery, and 20 per cent when done over twenty-four hours before surgery. The infection rate after razor preparation was not influenced by the presence or absence of visible injury. These findings suggest that although the depilatory preparation does not contribute to the risk of wound infection, the razor preparation has a definite adverse effect. Support is provided for the concept that bacterial liberation and growth after razor preparation injury is responsible for this adverse effect. Further, the microscopic injury that regularly accompanies the razor preparation is sufficient explanation without the necessity to implicate visible injury

Wound infections after preoperative depilatory versus razor preparation

The influence of the method of hair removal, razor versus depilatory, on the risk of postoperative wound infection was studied in 406 cases. The infection rate was 5.6 per cent after razor preparation, 0.6 per cent after depilatory, and 0.6 per cent after no preparation. After razor preparation, the infection rate was 3.1 per cent when done just prior to surgery, 7.1 per cent when done up to twenty-four hours prior to surgery, and 20 per cent when done over twenty-four hours before surgery. The infection rate after razor preparation was not influenced by the presence or absence of visible injury. These findings suggest that although the depilatory preparation does not contribute to the risk of wound infection, the razor preparation has a definite adverse effect. Support is provided for the concept that bacterial liberation and growth after razor preparation injury is responsible for this adverse effect. Further, the microscopic injury that regularly accompanies the razor preparation is sufficient explanation without the necessity to implicate visible injury