The Control of Infection in General Surgery: A Four-Year Prospective Study in Brazil

Abstract

Infection is an inherent complication in surgery. The high cost, the morbidity and the mortality to which it gives rise require that an effort be made to reduce its incidence. The control of the rates of infection constitutes today a parameter of the quality of the service provided by a hospital. In Brazil the unstructured nature of the vast majority of hospitals makes the recording of hospital infection and any attempt to control it a difficult task.Isolated studies have appeared in the Brazilian literature such as those of Hultzler et al on data from the São Paulo University Hospital, Zanon et al2 from Ipanema Hospital, Rio de Janeiro, and Ferraz et al from the Federal University of Pernambuco Teaching Hospital. Hultzler et al reported in 1973 that the incidence of acquired infection in the patients admitted to the São Paulo University Hospital was 5.95%. The overall rate of post-operative infection in 4,746 operations performed was 6.59%, while that of wound infection was 3.08%.In 1979 Zanon et al reported a 7.5% incidence of wound infection in the Division of General Surgery at Ipanema Hospital (Rio de Janeiro).In 1980 the National Enquiry on Post-Operative Infection was organized under the auspices of the Brazilian College of Surgeons. A questionnaire was sent to 3,225 members of the College throughout the country. Of the 107 questionnaires duly completed and returned (3.31%) only 86 (2.66%) reported controlling infection, and of these, 61 (1.89%) included the outpatient department within the scope of their control of infection. Only 20 of the 107 questionnaires returned gave what were considered answers with regard to surgical wound infection.