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• W2142296952 abstract "tion of the report: how frequently the hospitals reported such rates, what mechanisms they used to report the information, and what kinds of surgery and surgeons were covered. In addition, it is important to remember that there were many exclusions from the SENIC universe of hospitals and patients.2 All federal, state, and municipal hospitals were excluded, thus excluding many medical school hospitals and all Veterans Administration hospitals. Also excluded were all single specialty and children's hospitals, as well as all hospitals in Alaska, Hawaii, and those with less than 50 beds. Many surgical procedures and patients were excluded as well. None of the surgical specialties were included in the data base. Only cardiac, thoracic, and abdominal surgery, including ceasarean sections, were reviewed. These exclusions and processes suggest that the above SENIC interpretation of surgeon-specific wound infection rates has limited applicability. Furthermore, a follow-up survey several years later of the hospitals involved in this project showed that very few had adopted surgeon-specific wound infection rates.9 Several other studies have suggested a drop of surgical wound infection incidence-especially in the clean surgery categories-after surgeon-specific wound infection rates were introduced.3-s None of these studies had a concomitant prospective control. Most were done in a milieu where numerous other changes, such as introduction of intensive surveillance of wound infections, discontinuance of preoperative shaving of hair, changes in skin preparation, and changes in patterns of use of prophylactic antibiotics, were being made to control surgical wound infections at the same time. The lack of concurrent controls is important because it makes it difficult to ascertain the real reason for the decline in rates. The National Nosocomial Infection Control Study (NNIS) from the Centers for Disease Control (CDC) has shown a temporal decline in surgical wound infection rates during the same period when most of these studies were being done,'0 and the CDC's own follow-up survey of hospitals shows that less than 13% were calculating surgeon-specific wound infection rates.9 In reports from centers where active research protocols were being used to follow surgical wound infections prospectively, it is possible that at least some of the apparent reduction in infection rates may have been caused by a Hawthorne effect." @default.
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• W2142296952 date "1988-04-01" @default.
• W2142296952 modified "2023-09-26" @default.
• W2142296952 title "Surgeon-Specific Wound Infection Rates: A Potentially Dangerous and Misleading Strategy" @default.
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• W2142296952 doi "https://doi.org/10.1086/645817" @default.
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