Inability of patients to self-diagnose wound infections.

At the time of follow-up wound inspection or suture removal, 433 patients were questioned about signs of wound infection. Patients' answers were compared to evaluations by medical examiners. Patients frequently failed to recognize infection and signs of inflammation. When asked if wound infection was present, patients' false positive diagnostic rate was only 8%, but the false negative diagnostic rate was 48%. Medical examiners diagnosed wound infection in 21 wounds, and patients correctly identified their infections in only 11 of these cases. These results indicate that for the population studied, patients cannot be expected to recognize infection in their own wounds using verbal or printed instructions. Clinical investigators of wound healing should not use patient-reported data about wound infection that is obtained by telephone interview or other means.