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Korean Journal of Epidemiology 1981;3(1): 77-87.
수술후 창상감염에 대한 역학적 연구: 일개 도립병원 외과에서 수술받은 환자를 중심으로
조성종, 김정순
An epidemiologic study of postoperative wound infections
Sung Chong Cho, Joung Soon Kim
Postoperative wound infection has been frequent complications in surgical operations. The prevention of the infection in emergency and elective surgical wounds is the most important issue and problems for surgeons. The wound infection is still troublesome matter to surgeons despite the development of antiseptic technique and prophylaxis with antibiotics. Furthermore, the infection has become more serious problem in hospital practice throughout the country since antibiotic resistant bacteriae in hospital environment have increased. This study was carried out in order to understand epidemiologic characteristic of postoperative wound infections on cases of various surgical operation in a provincial hospital. All wounds were examined and followed up to about 7 days after operation by one surgeon. All purulent exudates of infected surgical wounds were cultured by swabbing the wound and then bacteriae were isolated. All specimens collected from nasal cavity, throat and skin of patients and surgical team members were also cultured for species identification. The results were matched with the bacterial species isolated from the surgical wound to assume source of the wound infection. The results obtained are as followings: 1. The overall wound infection rate was 10.5%, which was similar to other studies on postoperative wound infection reported. 2. The wound infection rate was about two times higher for the emergency operation than for the elective operation. 3. The wound infection rate by sex was similar and the rate is highest for the age group of 50’s among all age groups. 4. The wound infection by degree of contamination was 2.9% for clean operative wound, 12.4% for clean-contaminated operative wound, 22.4% for contaminated operative wound and 27.3% for dirty operative wound. 5. In the wound infection by preoperative hospitalization, it was found that the longer the duration of preoperative hospitalization, the more likely to develop wound infection. 6. In the wound infection by duration of operation the infection rate increased proportionately to the length of operation up to 3 hours, then slightly decreased thereafter. 7. By type of operation the infection rate varied; the operation of gastrointestinal tract revealed much higher infection rate due to fecal contamination compared with the clean operation such as thyroidectomy, herniorrhaphy or mastectomy. 8. Coagulase positive staphylococcus was most prevalent pathogen among bacterial species isolated from the infected wounds. 9. Bacteriological survey of surgical team members and patients to identify presumptive source of infection revealed that surgical team carried staphylococcus in 11.8%, streptococcus in 10.7%. The carrier rate was lower in scrub nurses and higher in patients among all subjects surveyed. 10. The most frequent suspected source of postoperative wound infection was surgical specimen, and 1.8% of the infection was from the skin of the patient himself. 11. The most prevalent bacterial species of airborne postoperative wound infection was coagulase positive staphylococcus. 12. The cleaning of operation room by using Ultraviolet ray, Helmet aspiration system, suction system or laminar air flow system and also surgical plastic drap may be used to reduce the wound infection.


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