Postdischarge Surveillance of Surgical Site Infection: Cesarean Section

Abstract

Background: Most surgical site infections occur after discharge and are not detected through standard surveillance methods, due the short postoperative hospital stay. Until now Maharat Nakhon Ratchasima Hospital’s surveillance has been conducted only during the inpatient stay. Objective: To obtain accurate surgical site infection rate of Cesarean section. Methods: A postdischarge questionnaire was sent to all woman who had undergone cesarean section during 1 Feb-30 Apr 2004 when discharged form hospital. Waiting 30 days after surgery for woman to return questionnaires by mail. A follow-up telephone interview was conducted if no questionnaire returned or to cleat the responses given to confirm the diagnosis of infection. Other methods used are surgeon questionnaires and information from Primary care unit (PCU). Results: A total response rate of 52.69% (274/520) was obtained. Average of hospital stay is 3.50 ± 1.05 days. Five women with surgical site infections (SSI) were identified through questionnaired responses. Additional 3 women were identified by telephone follow-up. The overall infection rate was 2.92% (8/274) compared with 0% at discharge. There are no statistical significance among emergency and elective cases, operative time at percentile 75 (T hour) and pre-op antibiotic prophylaxis. Conclusion: Postdischarge surveillance approaches need to achieve an optimal response rate, use standard definitions. The inclusion of contacting nonresponders in any method of postdischarge surveillance is recommended to determine the most accurate SSI rate.