Surgical sites and infections

Study

Patients recovering from surgery get infections far more often than is being reported, a study led by De Montfort University found.

Research into the way NHS Trusts in England record infections showed “worrying inconsistencies” between hospitals in how they defined surgical site infections (SSIs) and how rigorously they looked for them. As a result, published infection rates for hospitals do not always give a true picture.

The reasons hospitals gave for not submitting data was that the surveillance system was flawed and unwieldy and they didn’t trust the system. The research - published in the Journal of Hospital Infection - cast further doubt on the reliability of the national surgical site infection surveillance scheme in England.

It was reported that the national SSI surveillance system in England consistently under-reported the true scale of surgical infection and gave a false sense of security. The study showed there were so many inconsistencies that it was not possible to benchmark hospitals against the English national surgical site infection data.

Collaborative research

Specialists at De Montfort University, Southport and Newcastle universities sent out a questionnaire to all 156 NHS hospital trusts in England asking how they collected and reported data on post-operative wound infections for the national surgical site infection surveillance scheme. Replies were received from 106 (68%).

The results showed worrying inconsistencies between hospitals. For example, trusts which actively extended their surveillance to patients who had had knee replacement, after they had been discharged from hospital, reported an infection rate of 4.1%; hospitals that did not look so hard reported a lower rate, 1.5%.

It has resulted in a reduction in the number of SSIs, improving patients’ quality of life, shortening lengths of stay in hospital and making substantial cost savings for the NHS. The research has led directly to the development of policy and guidelines for various bodies including the World Health Organisation, the Department of Health, NICE and the Joint Commission Accreditation Healthcare Organisations (USA), as well as locally in a number of NHS trusts.