Surgical site infection: comparing surgeon versus patient self-report

Abstract

Background To compare the rate of surgical site infection (SSI) using surgeon versus patient report. Materials and methods A prospective observational study of surgical patients in four hospitals within one private health-care system was performed. Surgeon report consisted of contacting the surgeon or staff 30 d after procedure to identify infections. Patient report consisted of telephone contact with the patient and confirmation of infections by a trained surgical clinical reviewer. Results Between February 2011 and June 2012, there were 2853 surgical procedures that met inclusion criteria. Surgeon-reported SSI rate was significantly lower (2.4%, P value < 0.01) compared with patient self-report (4.3%). The rate was lower across most infection subtypes (1.3% versus 3.0% superficial, 0.3% versus 0.5% organ/space) except deep incisional, most proceduretypes (2.3% versus 4.4% generalsurgery) exceptplastics, most patient characteristics(except body mass index < 18.5), and all hospitals. There were disagreements in 3.4% of cases; 74 cases reported by patients but not surgeons and 21 cases vice versa. Disagreements were more likely in superficial infections (59.8% versus 1.0%), C-sections (22.7% versus 17.7%), hospital A (22.7% versus 17.7%), age < 65 y (74.2% versus 68.3%), and body mass index ≥ 30 (54.2% versus 39.9%). Conclusions Patient report is a more sensitive method of detection of SSI compared with surgeon report, resulting in nearly twice the SSI rate. Fair and consistent ways of identifying SSIs are essential for comparing hospitals and surgeons, locally and nationally.

Surgical Site Infections at a Saudi Hospital: The Need for a National Surveillance Program

“…Establishing high-quality surveillance programs with timely feedback to surgeons are essential tools for implementing further strategies to prevent SSIs occurrence and reducing their adverse effects, thereby reducing patients' risk of infection. 9,10 During the past three decades, various developed countries have initiated surveillance programs for SSI control, aiming at lowering infection rates by providing reliable estimates to hospitals and surgeons. Some of these programs published encouraging results, showing trends towards decreased SSI rates over time, at least for some operations.…”

Toxicity and Safety Study of D-PLEX100in a Sternal Surgical Defect in New Zealand White Rabbits

“…Surgical site infections (SSIs) are infections that involve the site of the surgical procedure and all the additional tissues that are involved in the surgery (ter Boo et al 2015). They can be divided into superficial or deep incisional, or organ or deep-space infections (Pham et al 2016). According to the U.S. Centers for Disease Control, SSIs were the second most common reason for hospital-acquired infections in 2002 and occurred in 2% of the surgical procedures (Klevens et al 2007).…”

Clinical prediction score for superficial surgical site infection after appendectomy in adults with complicated appendicitis

“…Patients should be advised about symptoms and signs of SSI before discharging home. Patient information sheets or self-assessment questionnaires may be useful [ 32 ].…”