Postoperative wound infection in 32,000 clean operations.

The frequencies of postoperative wound infection in clean operations have been registered at a county hospital (Falun, Sweden) during a 15-year period (1958-1972). A total of 64,000 operations were done and about 32,000 of these have been registered as clean operations. In 1968 the wards were transformed from 12-bed rooms to 5-bed rooms and the operating theatres were rebuilt. All premises were equipped with high pressure air ventilation including lock system. Furthermore, a new intensive care unit and a new awakening unit were built. The overall postoperative wound infection (sepsis) rate during this 15-year period was 1.7 percent. The infection rates in the 5-year period before and in the 5-year period after opening of the new buildings were the same: 1.6 percent. After adding postoperative infections (sepsis) and postoperative inflammatory reactions, the total rates were almost the same: 4.1 percent before and 4.2 percent after. A slight rise in staphylococcal infections has been registered. This rise might suggest that the expected positive effects of the new buildings have been counteracted by other exogenous and endogenous factors. Some of these factors have been discussed (rise in mean age etc.). On the basis of this investigation it seems likely that the management (in all respects) of the surgical patients is still of the greatest importance, regardless of fine new buildings.