Background: Because major complications are rare in day surgery, minor morbidities such as
surgical site infections, which become evident only after patient discharge, have a major impact
on the perceived quality of care. We performed an audit of such infections over a oneyear
period.
Methods: All procedures were performed in a multidisciplinary day surgery setting. There
were 155 inguinal hernia repairs, 44 excisions of lipomas, and 27 excisions of pilonidal cysts.
All patients received antibiotic prophylaxis according to a rotation protocol.
Results: One patient (0.65%) operated on for inguinal hernia developed a deep incisional
infection caused by Staphylococcus schleiferi. The patient was treated using selective antibiotics,
and complete recovery ensued. One patient (2.27%) who underwent excision of a lipoma
revealed developed a deep incisional infection associated with fever (39°C) caused by Staphylococcus
aureus. He was treated by daily antibiotics and application of dressings for two weeks
and recovered. One patient (3.7%) treated for pilonidal cyst developed a deep incisional surgical
site infection. A group A Streptococcus was isolated, and he received an intravenous antibiotic
for ten days. In the seven patients treated for pilonidal cyst with the wound left open,
swab specimens were taken because of persisting local pain, and the following bacteria were
found: Pseudomonas aeruginosa, Escherichia coli, Staphylococcus epidermidis, Proteus vulgaris,
and Streptococcus constellatus. No antibiotic therapy was given, and local wound care
led to complete recovery.
Conclusion: In our day surgery unit, the rates of surgical site infection are similar to those described
in the literature. Continuing audit is essential to maintain and improve the quality and
standard of the surgery provided. Prevention of surgical site infection is very much the responsibility
of the persons working in the operating theater. Therefore, it is vital not only to apply
strict regulations concerning everyday management but also to maintain a high degree of motivation
among the personnel.
