Post-discharge surveillance of wound infections by telephone calls method in a Sudanese Teaching Hospital.

UNLABELLED Surveillance of wound infections has been shown to be a powerful preventive tool, and feedback to the clinical staff reduces wound infection rates. The main objectives of this study were to identify the applicability of telephone calls as a method of post-discharge wound infection surveillance, and to identify patients and procedures characteristics associated with loss for follow-up after hospital discharge. MATERIALS AND METHODS This was a prospective cohort study conducted in Khartoum Teaching Hospital, Sudan. Patients, aged >18 years admitted for elective clean and clean-contaminated surgery during March 1st to 31st October 2010 were recruited. 1-month surveillance of wound infections was conducted with telephone interviews. RESULTS Overall 3656 patients were operated on. Of them 1769 (48.4%) were eligible {mean age 37.8+14 years; females, n=1472 (83.3%)}. The performed surgical interventions were 1814. Of these 1277 (70.4%) were clean-contaminated and 537 (29.6%) were clean. Patients who successfully completed the follow-up were 1387 (78.4%), while 368 (20.8%) were lost, and 14 (0.8%) died. The percentage of male patients (85.3%) who successfully completed the follow-up was significantly higher than females (77.8%); (P=0.002). Wound infection was detected in 15 (0.8%) cases during hospital stay and 110 (6.2%) others after hospital discharge. CONCLUSIONS The majority of wound infections in the current study appeared in post-discharge period; this emphasis the need for establishment of surveillance program in the hospital. Surveillance of wound infections using telephone calls is applicable in this setting and can be used as an alternative method to clinic-based diagnosis of wound infections.

[1]  J. Burke,et al.  Infection control - a problem for patient safety. , 2003, The New England journal of medicine.

[2]  R Platt,et al.  Efficient identification of postdischarge surgical site infections: use of automated pharmacy dispensing information, administrative data, and medical record information. , 1999, The Journal of infectious diseases.

[3]  Jennifer A. Roberts,et al.  Reduction in wound infection rates by wound surveillance with postdischarge follow‐up and feedback , 2006, The British journal of surgery.

[4]  A. P. Pinto Neto,et al.  Postdischarge surveillance following cesarean section: the incidence of surgical site infection and associated factors. , 2010, American journal of infection control.

[5]  J. Scott,et al.  Evaluation of surveillance for surgical site infections in Thika Hospital, Kenya , 2013, The Journal of hospital infection.

[6]  P. Gastmeier Postdischarge Surveillance for Surgical Site Infection: The Continuing Challenge , 2006, Infection Control & Hospital Epidemiology.

[7]  R. Gaynes,et al.  Consensus Paper on the Surveillance of Surgical Wound Infections , 1992, Infection Control & Hospital Epidemiology.

[8]  N. Cullum,et al.  Methods for identifying surgical wound infection after discharge from hospital: a systematic review , 2006, BMC infectious diseases.

[9]  J. Reilly,et al.  Caesarean section surgical site infection surveillance. , 2006, The Journal of hospital infection.

[10]  B. Grandbastien,et al.  Impact of a six-year control programme on surgical site infections in France: results of the INCISO surveillance. , 2007, The Journal of hospital infection.

[11]  R. Gaynes,et al.  CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. , 1992, Infection control and hospital epidemiology.

[12]  P. Aavitsland,et al.  [Infections after Caesarean sections]. , 2009, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke.

[13]  Diederick E Grobbee,et al.  Reduced risk of surgical site infections through surveillance in a network. , 2006, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[14]  R. Gaynes,et al.  Nosocomial infections in elderly patients in the United States, 1986-1990. National Nosocomial Infections Surveillance System. , 1991, The American journal of medicine.

[15]  W E Wilkinson,et al.  The Impact of Surgical-Site Infections in the 1990s: Attributable Mortality, Excess Length of Hospitalization, And Extra Costs , 1999, Infection Control & Hospital Epidemiology.

[16]  W. Martone,et al.  Recognition, prevention, surveillance, and management of surgical site infections: introduction to the problem and symposium overview. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[17]  W R Jarvis,et al.  Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. , 1999, Infection control and hospital epidemiology.

[18]  E. A. Petrova,et al.  Prospective Surveillance for Surgical Site Infection in St. Petersburg, Russian Federation , 2007, Infection Control & Hospital Epidemiology.

[19]  A. Emmerson,et al.  Surgical site infection surveillance. , 2000, The Journal of hospital infection.

[20]  R. Gibbs Infection after cesarean section. , 1985, Clinical obstetrics and gynecology.

[21]  Hassan Mshinda,et al.  Risk Factors for Surgical Site Infection in a Tanzanian District Hospital: A Challenge for the Traditional National Nosocomial Infections Surveillance System Index , 2006, Infection Control & Hospital Epidemiology.

[22]  T. Horan,et al.  Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. , 1999, American journal of infection control.

[23]  A. Oliveira,et al.  Post-discharge surgical site infection surveillance in a hospital in Brazil. , 2007, American journal of surgery.

[24]  Nongyao Kasatpibal,et al.  Surgical site infections in patients undergoing major operations in a university hospital: using standardized infection ratio as a benchmarking tool. , 2003, American journal of infection control.