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Wound Infection Rates in Clean Surgery: A Potentially Misleading Risk Classification

Published online by Cambridge University Press:  21 June 2016

Edmundo Machado Ferraz ,
Tercio Souto Bacelar ,
Jose Lamartine de Andrade Aguiar ,
Alvaro Antonio Bandeira Ferraz ,
Gilberto Pagnossin  and
Jose Edmilson Mazza Batista
Edmundo Machado Ferraz*
Affiliation:
Division of General Surgery, University Hospital of the Federal University of Arnambuco, Recife, Brazil
Tercio Souto Bacelar
Affiliation:
Division of General Surgery, University Hospital of the Federal University of Arnambuco, Recife, Brazil
Jose Lamartine de Andrade Aguiar
Affiliation:
Division of General Surgery, University Hospital of the Federal University of Arnambuco, Recife, Brazil
Alvaro Antonio Bandeira Ferraz
Affiliation:
Division of General Surgery, University Hospital of the Federal University of Arnambuco, Recife, Brazil
Gilberto Pagnossin
Affiliation:
Division of General Surgery, University Hospital of the Federal University of Arnambuco, Recife, Brazil
Jose Edmilson Mazza Batista
Affiliation:
Division of General Surgery, University Hospital of the Federal University of Arnambuco, Recife, Brazil
*
Av. Rosa e Silva, 2063, Tamarineira, Recife-PE, CEP-52020, Brazil
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Abstract

Objectives:

To evaluate the incidence of wound infection in inguinal hernioplasties, incisional hernioplasties, splenectomies, and splenectomies performed in patients with hepatosplenic schistomiasis, and to examine the relationship of surgical wound infection to antibiotic use, patient age, length of stay in the hospital prior to surgery, and the duration of the operation.

Design:

Retrospective surveillance study.

Results:

One thousand five hundred forty-two clean operations were analyzed. Comparing response (wound infection) and explanatory variables (age, length of hospital stay, duration of surgery, antibiotics, and surgery type), we found that age, use of antibiotics, and type of surgery were statistically significant, while length of hospital stay and duration of surgery were not significant.

Conclusions:

From these results, we can predict that the probability of wound infection in surgical patients considering these significant variables is lower for patients ages 14 to 30 years and higher for patients ages 31 to 60 years and lower for patients with prophylactic antibiotic use (up to 72 hours of use) and higher for patients with prolonged use (more than 72 hours); and lower for patients undergoing inguinal heria, followed in ascending order by nonschistosomotic patients undergoing splenectomy in schistosomotic patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 8 , August 1992 , pp. 457 - 462
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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References

1. Ferraz, EM. Manual de Controle de Infecçao em Cirurgia do Colégio Brasileiro de Cirurgioes. Sao Paulo, Brazil: Editora Pedagogica Universitaria Ltda; 1982.Google Scholar
2. Cruse, PJE, Foord, M. The epidemiology of wound infection. Surg Clin North Am. 1980;60:27–40.CrossRefGoogle ScholarPubMed
3. Garner, JS, Simmons, BI? CDC Guideline for the prevention and control of nosocomial infections. Guidelines for isolations precautions in hospitals. Am J Infect Control. 1984;12:103–106.CrossRefGoogle Scholar
4. Ferraz, EM. Surgeon-specific infection rates. Infect Control Hosp Epidemiol. 1988;9:184.CrossRefGoogle ScholarPubMed
5. Nichols, RL. Surveillance of the surgical wound. Infect Control Hosp Epidemiol. 1990; 11:513–14.CrossRefGoogle ScholarPubMed
6. Ferraz, EM. Mortalidade e custo da infecçao hospitalar no Brasil. Rev Col Bras Cir. 1984;11:7–8.Google Scholar
7. Cruse, PJE. Surgical infection: incisional wounds. In: Bennett, JV, Brachman, PS. Hospital Infections. 2nd ed. New York, NY: Little Brown and Company; 1986:423–436.Google Scholar
8. Ehrenkranz, NJ. Surgical wound infections: occurrence in clean operations. Am J Med. 1981;70:909–914.CrossRefGoogle ScholarPubMed
9. Haley, RW, Culver, DH, Morgan, WM, Emori, TG, White, JM. Identifying patients at high risk of surgical wound infection: a simple multivariate index of patients susceptibility and wound contamination. Am J Epidemiol. 1985;121:206–215.CrossRefGoogle ScholarPubMed
10. McLaws, ML, Irwing, LM, Mock, P, Berry, G, Gold, J. Predictors of surgical wound infections in Australia: a national study. Med J Aust. 1988;149:591–595.CrossRefGoogle ScholarPubMed
11. Houch, JP, Rypins, EB, Sarfeh, IJ, Juler, GL, Shimoda, KJ. Repair of incisional hernia. Surg Gynec Obstet. 1989;69:397–399.Google Scholar
12. Ferraz, EM, Corrêa Lima Filho, JE, Lima, FEA, Porfirio, L, Kelner, S. Infecçao pós-operatória na esquistossomose hepatoesplenica. Rev Col Bras Cir 1982;1:1–4.Google Scholar
13. Brote, L, Gillquist, J, Tarnvik, A. Wound infections in general surgery. Acta Chir Scand. 1976;142:99–106.Google ScholarPubMed
14. Marchesini, JB, Wiens, AM, Brenner, S, Malafaia, O, Cortes, AEC, Souza, FJ, Buffara, M. Esplenectomia em doenças hematologicas. Rev Med Parana. 1985;43:12–16.Google Scholar
15. Ellison, EC, Fabri, PJ. Complications of splenectomy, etiology prevention and management. Surg Clin North Am. 1983;63:313–1330.CrossRefGoogle ScholarPubMed
16. Ciofiro, W, Schein, CJ, Gliedman, ML. Splenic injury during abdominal surgery. Arch Surg. 1976;111:167–171.CrossRefGoogle Scholar
17. Curtis, SC, Aldridge, MC, Biglin, JEJ, Dye, J, Chadwick, SJD, Dudley, HAF. Effect of splenectomy on gram-negative bacterial clearance in the presence and absence of sepsis. Br J Surg. 1988;75:177–180.CrossRefGoogle Scholar
18. Di Cataldo, A, Puleo, S, Destri, GL, Racalbuto, A, Trombatone, G, Laterri, F, Rodolicço, G. Splenic trauma and overwhelming postsplenectomy infection. Br J Surg. 1987;74:343–345.CrossRefGoogle ScholarPubMed
19. Ferraz, EM. Infecçao da fetida na cirurgia do aparelho digestivo. Tese de Concurso público para Preenchimento de Vaga de Prof. Titular de Cirurgia Abdominal da Universidade Federai de Amambuco. Recife, Brazil: Federal University of Penambuco; 1990.Google Scholar
20. Davis, JM, Wolff, B, Cunninghan, TE. et al. Delayed wound infection. An 11-year survey. Arch Surg. 1982;117:113–117.CrossRefGoogle ScholarPubMed
21. Ferraz, EM, Lima, JFC, Porfirio, L, Kelner, S. The control of infection in general surgery: a four year prospective study in Brazil. Infect Control. 1985;6:356–360.CrossRefGoogle ScholarPubMed
22. Silveira, M, Vanderlei, MI, Kelner, S. Avaliaçao nutricional e imunologica em pacientes adultos candidatos a cirurgia do aparelho digestivo. Rev Col Bras Cir. 1987;14:133–141.Google Scholar
23. Francke, EL, Neu, HC. Postsplenectomy infection. Surg Clin N Am. 1981;61:135–155.CrossRefGoogle ScholarPubMed
24. Puleo, S, Di Cataldo, A, Bottaro, G, Sciotto, A, Schiliro, G, Latteri, F. Effects of splenectomy on lymphocyte recirculation. An experimental study. Ital J Surg Sci. 1982;12:117–121.Google Scholar
25. Najjar, VA, Nishioka, K. Tuftsin: a natural phagocytosis stimulating peptide. Nature. 1970;228:672–673.CrossRefGoogle ScholarPubMed
26. Bravo Neto, GP, Bravo, TP, Vieira, OM. Infecçao Pos-operatória no paciente idoso. Ars Curandi. 1986;19:83–93.Google Scholar
27. McCullagh, P, Neider, JA. Generalized Linear Models. London: Chapman and Hall; 1983.CrossRefGoogle Scholar
28. Dobson, AJ. Introduction to Statistical Modelling. London: Chapman and Hall; 1982.Google Scholar
29. Wetherill, GB. Intermediate Statistical Methods. London: Chapman and Hall; 1980.Google Scholar
30. Cordeiro, GM. Modelos lineares generalizados. VII Simposio Nacional de Probabilidade Estatistica. Sao Paulo, Brazil; 1986.Google Scholar