Inability of patients to self-diagnose wound infections

Seaman, Matthew; Lammers, Richard L.

doi:10.1016/0736-4679(91)90416-d

Cited by 70 publications

(52 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The validity of the information obtained from patients and physicians and whether the diagnosis of SSI can be based on this is a matter of dispute in several research studies. Seaman and Lammers 22 found that patients, despite using verbal or printed instructions, were unable to recognize infections. They reported that patients correctly identified their infections in only 11 cases, whereas medical examiners diagnosed infection in 21 wounds, and called into question the validity of data obtained using patientreturned questionnaires or telephone surveys.…”

Section: Discussionmentioning

confidence: 99%

Surgical-Site Infections Following Cesarean Section in an Estonian University Hospital: Postdischarge Surveillance and analysis of Risk Factors

Mitt

Lang

Peri

et al. 2005

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

OBJECTIVES:To evaluate a multi-method approach to postdischarge sur veillance of surgical-site infections (SSIs) and to identify infection rates and risk factors associated with SSI following cesarean section.DESIGN: Cross-sectional sur vey. SETTING: Academic tertiar y-care obstetric and gynecology center with 54 beds.PATIENTS: All women who delivered by cesarean section in Tartu University Women's Clinic during 2002.METHODS: Infections were identified during hospital stay or by postdischarge sur vey using a combination of telephone calls, healthcare worker questionnaire, and outpatient medical records review. SSI was diagnosed according to the criteria of the Centers for Disease Control and Prevention National Nosocomial Infections Sur veillance System. RESULTS:The multi-method approach gave a follow-up rate of 94.8%. Of 305 patients, 19 (6.2%; 95% confidence inter val [CI 95 ], 3.8-9.6) had SSIs. Forty-two percent of these SSIs were detected during postdischarge sur veillance. We found three variables associated with increased risk for developing SSI: internal fetal monitoring (odds ratio [OR], 16.6; CI 95 , 2.2-125.8; P = .007), chorioamnionitis (OR, 8.8; CI 95 , 1.1-69.6; P = .04), and surgical wound classes III and IV (OR, 3.8; CI 95 , 1.2-11.8; P = .02). CONCLUSIONS:The high response rate validated the effectiveness of this kind of sur veillance method and was most suitable in current circumstances. A challenge exists to decrease the frequency of internal fetal monitoring and to treat chorioamnionitis as soon as possible (Infect Control Hosp Epidemiol 2005;26:449-454). ABSTRACTThe single most important risk factor for postpartum maternal infection is delivery by cesarean section.1 Maternal morbidity related to infections has been shown to be eightfold higher after cesarean section than after vaginal delivery.2 Reducing the number of deliveries by cesarean section and identifying risk factors for post-cesarean surgical-site infections (SSIs) could contribute to a decrease in maternal morbidity.

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical-Site Infections Following Cesarean Section in an Estonian University Hospital: Postdischarge Surveillance and analysis of Risk Factors

Mitt

Lang

Peri

et al. 2005

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…These criteria were designed to reduce misclassification of infection, since Seaman and Lammers have shown that patient self-diagnosis of infection is unreliable. 22 Finally, our patient population may not be representative of all other ED patients with lacerations. We had a low prevalence of immunocompromised patients.…”

Section: Limitations and Future Questionsmentioning

confidence: 99%

Risk Factors for Infection in Patients with Traumatic Lacerations

Hollander

Singer

Valentine

et al. 2001

Academic Emergency Medicine

103

View full text Add to dashboard Cite

Abstract. Background: Most of our knowledge of laceration management comes from studies in animal models or patients with closure of sterile postoperative surgical incisions. Traumatic laceration management has not been well studied. Objective: To determine which characteristics of traumatic lacerations were associated with the development of wound infection. Methods: A cross-sectional study of consecutive patients with traumatic lacerations repaired over a four-year period was conducted. Structured closedquestion data sheets were prospectively completed at the time of laceration repair and suture removal. Infection was determined at the time of suture removal. Multivariate modeling was used to determine the adjusted odds ratio (OR) of infection. Results: Five thousand five hundred twenty-one patients were enrolled; 195 patients developed an infection (3.5%). An increased likelihood of wound infection was associated with age (adjusted OR per year, 1.01; 95% CI = 1.0 to 1.02); history of diabetes mellitus (adjusted OR 6.7; 95% CI = 1.7 to 26.4); laceration width (adjusted OR 1.05 per mm; 95% CI = 1.02 to 1.08); and presence of foreign body (adjusted OR 2.6; 95% CI = 1.3 to 5.2). Laceration location on the head/neck was associated with a decreased risk of infection (adjusted OR 0.28; 95% CI = 0.18 to 0.45). Conclusions: Both patient and wound characteristics of traumatic lacerations have an influence on the likelihood of infection. This knowledge may be valuable for determining whether various methods of wound cleansing, debridement, and repair can improve the outcome of patients with traumatic lacerations. Key words: wounds; lacerations; sutures; infection; cosmetic appearance; outcomes. ACADEMIC EMERGENCY MEDICINE 2001; 8:716-720 L ACERATIONS and open wounds are the third most commonly encountered problems in the emergency department (ED), accounting for 8% of the 95 million annual ED visits in the United States.1 The ultimate goals of wound management are to avoid infection and achieve a functional and cosmetically acceptable scar.2,3 Although death and life-threatening morbidity from traumatic lacerations are rare, improper management may lead to an increased likelihood of wound infection and a decreased likelihood of achieving a cosmetically appealing outcome. These largely avoidable outcomes may result in significant patient inconvenience or long-term psychological sequelae.Most studies of wound care have focused on postoperative infection rate.3-9 Current practices are generally derived empirically, based on obser- vations in animal models or extrapolation from data derived in the operating room. Data derived from the animal laboratory usually result from a model where between 10 5 and 10 9 bacterial colonies are inoculated into surgical incisions. [10][11][12][13][14][15] Extrapolation to the clinical setting where most lacerations may have less than 10 2 bacterial colonies is unclear. 16,17 Likewise, extrapolation from the setting of elective operative incisions to the ED setting is also of unclear si...

show abstract

“…The ability of patients to accurately diagnose surgical wound infection was expanded on in the first section of this chapter, but an example was described of the inability of patients to recognise discharge material as purulent. 173 Furthermore, some definitions distinguish and exclude stitch abscess, a distinction that patients may not be able to make. Ideally, an independent trained examiner would be more objective than would a judgement made by the patient or surgeon.…”

Section: Data Collection In the Communitymentioning

confidence: 99%

“…51,173 In 1999, Mitchell and co-workers 51 compared rates of patientreported and physician-reported surgical wound infection in patients undergoing major elective surgery. On discharge, each patient was given a simple questionnaire to be completed and returned after 1 month, and surgeons received a mail-back form to be completed at postoperative review.…”

Section: Validation Of Patient Self-diagnosismentioning

confidence: 99%

The measurement and monitoring of surgical adverse events

Bruce

Russell

Mollison

et al. 2001

Health Technol Assess

295

209

View full text Add to dashboard Cite

Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK.We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAThe measurement and monitoring of surgical adverse events NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme.Although the National Coordinating Centre for Health Technology Assessment (NCCHTA) commissions research on behalf of the Methodology Programme, it is the Methodology Group that now considers and advises the Methodology Programme Director on the best research projects to pursue.The research reported in this monograph was funded as project number 97/16/04.The views expressed in this publication are those of the authors and not necessarily those of the Methodology Programme, HTA Programme or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit supp...

show abstract

Inability of patients to self-diagnose wound infections

Cited by 70 publications

References 18 publications

Surgical-Site Infections Following Cesarean Section in an Estonian University Hospital: Postdischarge Surveillance and analysis of Risk Factors

Surgical-Site Infections Following Cesarean Section in an Estonian University Hospital: Postdischarge Surveillance and analysis of Risk Factors

Risk Factors for Infection in Patients with Traumatic Lacerations

The measurement and monitoring of surgical adverse events

Contact Info

Product

Resources

About