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The quality of measurement of surgical wound infection as the basis for monitoring : a systematic review
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Bruce, J. (Julie), Russell, E. M., Mollison, J. and Krukowski, Z. H. (2001) The quality of measurement of surgical wound infection as the basis for monitoring : a systematic review. Journal of Hospital Infection, 49 (2). pp. 99-108. doi:10.1053/jhin.2001.1045
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Official URL: http://dx.doi.org/10.1053/jhin.2001.1045
Abstract
Comparison of postoperative surgical wound infection rates between institutions and over time is only valid if standard, valid and reliable definitions are used. The aim of this review was to assess evidence of validity and reliability of the definition and measurement of surgical wound infection. A systematic review was undertaken of prospective studies of surgical wound infection published over a seven-year period; 1993-1999. The information extracted from individual studies included: definition of surgical wound infection; details of wound assessment scale, scoring or grading scale systems; and evidence of assessment of validity, reliability and feasibility of identified definitions and grading systems. Two independent reviewers appraised 112 prospective studies, 90 of which were eligible for inclusion; eight studies assessed validity and/or reliability. Forty-one different definitions of surgical wound infection were identified, five of which were 'standard' definitions proposed by multi-disciplinary groups. Presence of pus was the most frequently used single component of any definition; the CDC definitions of 1988 and 1992 were the most widely implemented standard definitions; and the ASEPSIS wound assessment scale was the most frequently used quantitative grading tool. Only two formal validations of a definition were found, and six studies of reliability. This review highlights the extent of variation in definition of surgical wound infection used in clinical practice, and the need for validation of both content and organization of a surveillance system. However, realistically, there will have to be a balance between the quality of the measurement and the practicality of surveillance.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Journal or Publication Title: | Journal of Hospital Infection | ||||||
| Publisher: | W B Saunders Co Ltd. | ||||||
| ISSN: | 0195-6701 | ||||||
| Official Date: | October 2001 | ||||||
| Dates: |
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| Volume: | 49 | ||||||
| Number: | 2 | ||||||
| Page Range: | pp. 99-108 | ||||||
| DOI: | 10.1053/jhin.2001.1045 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| Funder: | Health Technology Assessment (HTA) Programme | ||||||
| Grant number: | 97/16/04 |
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