The quality of measurement of surgical wound infection as the basis for monitoring: a systematic review

Julie Bruce, Elizabeth M Russell, Jill Ann Mollison, Zygmunt H Krukowski

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Comparison of postoperative surgical wound infection rates between institutions and over time is only valid if standard, valid and reliable definitions are used. The aim of this review was to assess evidence of validity and reliability of the definition and measurement of surgical wound infection. A systematic review was undertaken of prospective studies of surgical wound infection published over a seven-year period; 1993-1999. The information extracted from individual studies included: definition of surgical wound infection; details of wound assessment scale, scoring or grading scale systems; and evidence of assessment of validity, reliability and feasibility of identified definitions and grading systems. Two independent reviewers appraised 112 prospective studies, 90 of which were eligible for inclusion; eight studies assessed validity and/or reliability. Forty-one different definitions of surgical wound infection were identified, five of which were 'standard' definitions proposed by multi-disciplinary groups. Presence of pus was the most frequently used single component of any definition; the CDC definitions of 1988 and 1992 were the most widely implemented standard definitions; and the ASEPSIS wound assessment scale was the most frequently used quantitative grading tool. Only two formal validations of a definition were found, and six studies of reliability. This review highlights the extent of variation in definition of surgical wound infection used in clinical practice, and the need for validation of both content and organization of a surveillance system. However, realistically, there will have to be a balance between the quality of the measurement and the practicality of surveillance. (C) 2001 The Hospital Infection Society.

Original languageEnglish
Pages (from-to)99-108
Number of pages9
JournalJournal of Hospital Infection
Volume49
Issue number2
DOIs
Publication statusPublished - 2001

Keywords

  • surgical wound infection
  • review
  • reproducibility of results
  • sensitivity and specificity
  • PERCUTANEOUS ENDOSCOPIC GASTROSTOMY
  • ELECTIVE COLORECTAL SURGERY
  • ANTIBIOTIC-PROPHYLAXIS
  • DOUBLE-BLIND
  • SITE INFECTIONS
  • CDC DEFINITIONS
  • SCORING METHOD
  • SURVEILLANCE
  • TRIAL
  • COMPLICATIONS

Cite this