By MARTIN JOHNSTON
More than 12 per cent of surgical patients studied at Christchurch Hospital suffered wound infections, despite being in a group considered to be at the lowest risk of contamination.
Researchers at the hospital checked a group of 1934 patients who received so-called "clean-wound" surgery.
Wounds and surgery are graded by degree of expected contamination. A "dirty" wound would be expected if, for instance, a dairy farmer suffered a broken leg in which the bone pushed through the skin and was contaminated with cow dung.
Clean-wound surgery is free from contamination, either external, or internal from organs such as the bowel or a gall bladder contaminated with bacteria.
A report of the study in the latest Australia New Zealand Journal of Surgery says 12.6 per cent of the study participants suffered infections, a third of them while in hospital, and two-thirds within 30 days of being discharged.
This was higher than expected and is more than four times the acceptable 3 per cent threshold for clean-wound infections set by the Australian Council of Healthcare Standards.
One of the researchers, Professor Frank Frizelle, a Christchurch Hospital surgeon, said New Zealand relied on the standards, but they were unrealistic.
"They take it at five days post-operatively, but they are wrong [to do so].
"The thrust of the journal article is that if you do that you will miss out on a large percentage of wound infections because they actually occur after that time."
He said the findings suggested that infections after surgery were more common than surgeons recognised.
They would be aware of infections that began in hospital, but not those that flared up after patients were discharged, because those patients would be under the care of a general practitioner.
The article says that shorter hospital stays are a factor contributing to surgeons' reduced appreciation of wound infection rates.
When asked if it mattered that surgeons were unaware of discharged patients' infections, he said that surgeons needed to know about complications so they could advise people of the risks of particular procedures.
Standard surgical risk factors, such as the patient's fitness and the length of the operation, were "not that relevant" for most post-operative wound infections.
In the study, vascular surgery was found to carry the highest risk of post-operative infection at 18.3 per cent, and head and neck surgery the lowest at 7.1 per cent.
In between were breast surgery at 16 per cent , abdominal at 10.3 per cent and hernia at 8 per cent.
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