Surgical site infection in orthopaedic surgery: an audit of peri-operative practice at a tertiary centre
Peter Tao C D , Caroline Marshall A B and Andrew Bucknill C
+ Author Affiliations
- Author Affiliations
A Victorian Infectious Diseases Service, Melbourne Health, The Peter Doherty Institute, Parkville, Vic. 3050, Australia.
B Department of Medicine, Royal Melbourne Hospital Campus, University of Melbourne, Parkville, Vic. 3010, Australia.
C Department of Surgery, Royal Melbourne Hospital, Parkville, Vic. 3050, Australia.
D Corresponding author. Email: peter.tao@hotmail.com
Healthcare Infection 20(2) 39-45 https://doi.org/10.1071/HI14030
Submitted: 12 August 2014 Accepted: 22 December 2014 Published: 19 March 2015
Abstract
Introduction: Surgical site infection (SSI) is a common but serious complication in orthopaedic surgery. Multiple peri-operative risk factors have been identified in the incidence of SSIs. A ‘bundle of care’ approach has been used to identify and treat the most common risk factors. The aim of this study was to audit current peri-operative practice and compare with current hospital protocols.
Methods: Orthopaedic surgeries were retrospectively audited at a 350-bed tertiary hospital. Data on peri-operative practice, including patient temperature, blood sugar levels (BSLs), oxygenation, antibiotic use and incidence of SSIs, were collected via online surveying software. Descriptive analysis was performed.
Results: There were a total of 88 patients who had 95 orthopaedic surgeries. Seven patients developed SSIs. Temperature monitoring occurred in 96% of patients. BSL monitoring was less prevalent, occurring in only 16% of patients without diabetes. Post-operative oxygenation was universal. Only three patients did not receive prophylactic antibiotics in the peri-operative stage.
Conclusions: We found current peri-operative care to be generally excellent, although implementing a formal ‘bundle of care’ may achieve higher rates of normoglycaemia and normothermia.
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