UNDERESTIMATION OF SURGICAL SITE INFECTION-RATES IN OBSTETRICS AND GYNECOLOGY

Background: With the increasing volume of same-day operations and shor tened hospital stays, it becomes more likely that a significant percen tage of surgical site infections will occur after these patients' disc harges. Methods: To document the true incidence of postdischarge surgi cal site infection, surveillance was undertaken in a group of obstetri c and gynecologic patients. The study consisted of two parts. (1) A qu estionnaire was mailed to each surgeon, inquiring about clinical evide nce of infection. The infection control service continued to do survei llance of wound infection in the usual manner, and the results of the two methods were compared. (2) A questionnaire was provided to patient s undergoing operation, inquiring about signs and symptoms of wound in fection. Results: A total of 469 surgical procedures were included, wi th a total of 24 infections detected (5.2%). Of these, 14 infections ( 58.3%) were detected by the usual surveillance method. An additional 1 0 infections (41.7%) were detected after patient discharge by the phys ician questionnaire. Only two of the 24 infections were detected by th e patient questionnaire. Conclusions: Failure to include postdischarge surgical site surveillance results in a substantial underestimation o f the true surgical site infection rate. Physician input and strong su pport have prompted a regular biannual postdischarge surgical site sur veillance program in this patient population.