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Wound Infection in an Orthopaedic Unit

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WOUND INFECTION IN AN ORTHOPAEDIC UNIT J. G. CAMBLIN, F.R.C.S.,* Senior Orthopaedic Registrar, Department of Orthopaedics, Musgrave Park Hospital, Belfast and DR. E. S. MITCHELL, F.R.C.P., Consultant Pathologist, Musgrave Park Hospital, Belfast * Now Fellow of Orthopaedic Oncology, University of Florida, Gainesville, Florida. WOUND INFECIION IN AN ORTHOPAEDIC UNIT RECENTLY, attention has gradually moved away from the quantity and technique of surgical procedures towards the quality of the work. It is in this vein that this study was focused on wound infection following orthopaedic surgery. This has been studied in other centres and the reported incidence has varied from 1.68 per cent (Wilson et al. 1972) to as high as 19.8 per cent when hip arthroplasty alone has been considered (Patterson and Brown 1972; Bingham, Fleenor and Church 1974). Most authors have a reported wound infection rate of 4 to 11 per cent for total hip arthroplasty (Cruess, Bickel and von Kessler 1975, McKee and Watson-Farrar 1966, Bergstrom, Lidgren and Lindberg 1974) and, with the introduction of a laminar air-flow tent, this incidence has been reduced to 3.8 per cent (Charnley 1972, Dupont and Charnley 1972). The main organisms cultured from the wounds in the reported series were Staphlococcus aureus, E. coli and Pseudomonas spp. This study reports the incidence of wound infection in an orthopaedic unit over a five-year period. The theatre system used by this unit was not equipped with the sophistication of laminar air-flow systems and systematic antibiotic prophylaxis was not a policy of this unit, even in total hip replacement. PATIENTS AND METHODS Information regarding the number of patients treated in the orthopaedic unit and the nature of their surgical procedures was obtained from the theatre records. The number of patients whose wounds subsequently became infected during the study period, from 1st January 1970 to 30th April 1975 inclusive, was obtained from the records of the bacteriology laboratory at Mus

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