Abstract
In a six-month incidence study of surgical wound infections (SWI) in two Italian hospitals, 1,019 surgical patients, in three general surgery wards, and 433 surgical patients in one orthopedics ward were studied. For the SWI surveillance, the DANOP-DATA system was used: this microcomputer program was developed by Danish authors and tested in a European multicenter study coordinated by the World Health Organization in 1989. Two Italian hospitals participated in the multicenter study. The overall infection rate was 1.2 per 100 operations in orthopedics and 4.9/100 in general surgery. The risk of infection increased with age (RR = 2.06; 95% CL = 1.20–3.53), wound class (RR = 3.38; 95% CL = 1.97-5.8), length of pre-operative stay (RR = 2.71; 95% CL = 1.54-4.74), and duration of operation (RR = 2.59; 95% CL = 1.48–4.54).
The infection rates ranged from 3.7 to 7.3/100 among the three general surgery wards; this variability by ward was only partially explained by differences in the age distribution of in-patients, wound class, duration of operation and length of pre-operative stay. When all these risk factors were simultaneously taken into account using a logistic regression model, the odds ratio, comparing one of the three general surgical wards with the other two, was still 2.29 (95% CL = 1.23–4.26). The observed variability can be attributed to differences, among the participating wards, in the case-mix of patients treated and/or to differences in the quality of infection control programs implemented.
Similar content being viewed by others
References
American College of Surgeons, Committee on Control of Surgical Infections (1984): Manual on control of infections in surgical patients. 2nd ed. J.B. Lippincott, Philadelphia.
American College of Surgeons, Committee on Control of Surgical Infections of the Committee on Pre- and Postoperative Care. Altheimer W.A., Burke J.F., Pruitt B.A., Sandusky W.R. (eds). (1984): Manual on Control of Infections in Surgical Patients. JB Lippincott Company, Philadelphia.
BrownR.B., BradleyS., OpitzE., CiprianiD., PieczarkaR., SandsM. (1987): Surgical wound infections documented after hospital discharge. Am J Infect Control, 15: 54–58.
Centers for Disease Control. (1981): Outline for Surveillance and Control of Nosocomial infections. Appendix 11: Guidelines for determining presence and classification of infection. Centers for Disease Control, U.S. Department of Health, Atlanta.
Centers for Disease Control. (1985): Guidelines for the prevention of surgical wound infections. Centers for Disease Control, US Department of Health, Atlanta.
CruseP., FoordR. (1980): The epidemiology of wound infections. Surg Clin North Am, 60: 27–40.
Department of Biomathematics, University of California (1985): BMDP Statistical Software. University of California, Los Angeles.
EhrenkranzN.J. (1981): Surgical Wound Infection Occurrence in Clean Operations. Risk Stratification for Interhospital Comparisons. Am J Med, 70: 909–914.
Gil-EgeaM.J., Pi-SunyerM.T., VerdaguerA., SanzF, Sitges-SerraA., Torre EleizeguiL. (1987): Surgical wound infection: Prospective study of 4,468 Clean wounds. Infect Control, 8 (7): 277–280.
HaleyR.W., HootonT.M., CulverD.H., StanleyR.C., EmoriT.G., HardisonC.D., QuadeD., SchachtmanR.H., SchabergD.R., ShahB.V., SchatzG.D. (1981): Nosocomial infections in U.S. hospitals, 1975–1976. Estimated frequency by selected characteristics of patients. Am J Med, 70: 947–959.
HaleyR.W., CulverD.H., WhiteJ.W., MorganT.M., EmoriG.B., MunnV.P., HootonT.M. (1985): The efficacy of infection surveillance and control programs in preventing nosocomial infections in U.S. hospitals. Am J Epidemiol, 121: 182–205.
HootonT.M., HaleyR.W., CulverD.H., White J.W., Meade MorganW. (1981): The Joint Associations of Multiple Risk Factors with the Occurrence of Hospital Infection. Am J Med, 70: 947–959
HoranT.C., WhiteJ.W., JarvisW.R., EmoriT.G., CulverD.H., MunnV.P., ThornsberryC., OlsonD.R., HughesJ.M. (1985): Nosocomial Infection Surveillance, 1984. MMWR, 35 (Suppl. 1): 17–29.
KaiserA.B. (1982): Effective and Creative Surveillance and Reporting of surgical wound infections. Infect Control, 3 (1): 41–43.
KjaeldgaardP., CordtzT., SejebergD., KjaersgaardE., SillemannM.P., La Cour AndersenJ., JepsenO.B. (1989): The DANOP DATA system: A low-cost personal computer base program for monitoring of wound infections in surgical ward. J Hosp Infect, 13: 273–279.
LarsonE., OramL.F., HedrickE. (1988): Nosocomial Infection Rates as an Indicator of Quality. Medical Care, 26 (7): 676–684.
LeighD.A. (1981): An eight year study of postoperative wound infection in two district hospitals. J Hosp Infect, 2: 207–217.
MozzilloN., GrecoD., PesciniA. (1988): Chemoprophylaxis in Surgical Wards: results of a national survey in Italy. European J Epidemiol, 4 (3): 343–348.
National Research Council Division of Medical Science, Ad Hoc Committee of the Committee of Trauma. (1964): Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and various other factors. Ann Surg, 160 (2): 9–192.
NorusisM.J. (1986): SPSS/PC for the IB PC/XT/AT. SPSS Inc., Chicago.
OlsonM., O'ConnorM., SchwartzM.L. (1984): Surgical wound infections. A 5-year prospective study of 20,193 wounds at the Minneapolis VA Medical Center. Ann Surg, 199 (3): 253–259.
PelleH., JepsenO.B., LarsenS.O., ChristensenF., DreislerA., JorgensenP.J., KirsteinA., KjollerM., LangeA., LaursenK., NickelsenC.A.N., OslerM., RasmussenH. (1986): Wound infection after Caesarean Section. Infect Control, 7: 456–461.
ReimerK., GleedC., NicolleL.E. (1987): The impact of post-discharge infection on surgical wound infection rates. Infect Control, 8 (6): 237–240.
SchecklerW.E. (1988): Surgeon-Specific Wound Infection Rates — A Potentially Dangerous and Misleading Strategy. Infect Control and Hosp Epidemiol, 9 (4): 145–146.
ScroccaroG., FalconiM., MartiniN. (1987): S.I.P.A.C.: Studio italiano sulla profilassi antibiotica in Chirurgia. Giornale Italiano di Farmacia Clinica, 1 (2): 68–74.
SimchenE., WaxY., PevsnerB. (1988): The Israeli Study of Surgical Infections (ISSI): 11. Initial Comparison Among Hospitals With Special Focus on Hernia Operations. Infect Control, 9: 241–249.
Author information
Authors and Affiliations
Additional information
Corresponding Author
Rights and permissions
About this article
Cite this article
Moro, M.L., Sommella, L., Gialli, M. et al. Surgical infections surveillance: Results of a sixmonth incidence study in two Italian hospitals. Eur J Epidemiol 7, 641–648 (1991). https://doi.org/10.1007/BF00218675
Issue Date:
DOI: https://doi.org/10.1007/BF00218675