일반외과 환자에서의 수술 후 창상감염에 관한 조사

Abstract

Background : Surgical wound infections are still a major cause of patien's mortality and morbidity. These lead to extended stays at the hospital and to a rise in health care costs. About 30% of surgical wound infections can be prevented by effective infection control management. Surveillance provides the base for infection control management. Methods : This study examined 585 wound cases over a 4 month-period from Sep. 1, 1993 to Dec. 31, 1993 in the department of general surgery at Yonsei Medical Center. The CDC definitions of surgical wound infections were used. An infection control nurse visited the wards every other day, reviewed patients' charts and observed wounds regularly. Results : We found 40 cases of surgical wound infection(6.84%). The infection rate of clean wounds was 2.78%. Superficial surgical wound infection rate was 60% and deep surgical wound infection rate was 40%. Five of the forty(12.5%) surgical wound infections were found during an outpatient visit after discharge. Staphylococcus aureus, pseudomonas aeruginosa and Escherichia coli were the most frequently isolated organisms. S. aureus were all MRSA(Methcillin resistant S. aureus). Conclusion : We suggest that activation of infection control department be an immediate priority. Multi-dimensional(involving nurses, surgeons, and the infection control department) efforts are needed to reduce surgical wound infections.