[A measurable connection between preventative interventions and the incidence of postoperative wound infection]. / Meetbaar verband tussen preventieve interventies en de incidentie van postoperatieve wondinfecties.

OBJECTIVE: To establish whether there was a link between the preventative interventions executed and two groups of patients: those with and those without a postoperative wound infection (POWI). DESIGN: Descriptive and comparative research. METHOD: At Rijnland Hospital, a Dutch non-academic teaching hospital, 284 indicator operations were carried out between 1 April 2009 and 31 March 2010. We investigated whether preventative interventions were carried out during these operations. The types of surgery included mastectomy with and without axillary node dissection, resection of the colon and central vascular surgery (reconstruction of the aorta via an endovascular or open approach). Four types of intervention were studied: hygienic discipline (measurement of the number of times the operating theatre doors moved), the timely administration of preoperative antibiotic prophylactics, the avoidance of preoperative shaving and the attempts at perioperative normothermia. A 'postoperative wound infection' was registered as such if it had developed within 30 days of surgery. RESULTS: In total, 22 POWIs (7.7%) were registered, arising from 284 operations: 5 POWIs (2.8%) after mammary surgery, 1 POWI (2.8%) after central vascular surgery, and 16 POWIs (21.6%) after colon surgery, respectively (see table 2). Meeting the criteria of all 4 types of intervention had no influence on the development of a POWI. A significant association to the development of a POWI was, however, determined to be the variables related to wound classification, duration of surgery and the average number of door movements per hour during surgery; specifically, 7 or more. CONCLUSION: Surveillance by way of registration and feedback of interventions and their optimisation, particularly in terms of door movement, can possibly contribute to a reduction in the number of postoperative would infections.