A PROSPECTIVE, RANDOMIZED SURVEILLANCE STUDY OF POSTOPERATIVE WOUND INFECTIONS AFTER PLASTIC-SURGERY - A STUDY OF INCIDENCE AND SURVEILLANCE METHODS

In a postoperative wound infection study in plastic surgery, 315 patie nts were randomized to either outpatient wound control after 30 days ( group I) or self-control by questionnaire (group II). We present a new definition of wound infection based on physiologic wound healing. The surveillance of postoperative wound infection showed follow-up rates of 95 and 68 percent and infection rates of 16.3 and 17.1 percent for groups I and II, respectively. Of the 43 patients (16.7 percent) with postoperative wound infections, 31 (72 percent) were diagnosed after l eaving the hospital, and only 12 (28 percent) were diagnosed during ho spital stay. The monthly wound infection rate declined from 23.5 perce nt when the registration started to 12.2 percent at the end of the sur veillance. The wound infection rate nearly tripled when duration of su rgery was more than 120 minutes compared with less than 60 minutes. Po stoperative wound infection was significantly related to preoperative contamination class, with an increase from 10.2 percent wound infectio ns in class ''clean'' to 37.5 percent in class ''dirty.'' We conclude that postoperative wound infection also crops up in the plastic surgic al department, and this situation has not, to date, been documented su fficiently. A simple questionnaire gives a useful survey of postoperat ive wound infections. An active follow-up for at least 30 days is esse ntial to register the late of surgical infections.