Wound infection surveillance.

This paper describes a prospective study of all surgical wounds of patients at the Foothills Hospital (Calgary, Alberta, Canada) during a period of 10 years to determine the rate of infection of surgical wounds and to assess the factors that influenced this rate. My colleagues and I found that the overall infection rate was 4.7% but that the rate of infection of clean wounds was 1.5%; this latter rate proved to be far more useful than the former as an indicator of control of infections of surgical wounds. Endogenous contamination at the time of operation is more important as a cause of infection than is exogenous contamination. Having the patient shower with an antiseptic agent before the operation and not shaving the operative site reduced the clean wound infection rate. Use of adhesive plastic drapes did not reduce the infection rate. Glove punctures did not prove hazardous. Advanced age of the patient, prolonged preoperative hospitalization, and long operations were associated with an increase in the rate of infection of surgical wounds.