Contamination of postoperative head and neck wounds with urogenital microbes

Objectives. To investigate the impact of mixing surgical subspecialty patients on postoperative wound infections. Method. A retrospective analysis of postoperative wound infections in head and neck surgery patients before and after mixing them with urology patients. We selected two periods that are identical in duration and seasonal spread. The first was from March 2005 to November 2005 and the second was from March 2006 to November 2006. Results. 1381 patients underwent head and neck surgery at our institute in the two periods; 705 in the first and 676 in the second. The number of patients with positive swabs was 19 (2.7%) in the first group and 28 (4.1%) in the second group. Positive swabs (infective episodes) increased from 93 (13.2%) to 135 (20%) and the monthly breakdown of the two periods showed a statistically significant increase (P = 0.047). Urogenital microorganisms were the main factor contributing to the increase in wound infection rates in the second period (P = 0.008). Other organisms like MRSA, remained statistically unchanged (P = 0.464). Conclusions. We recommend that head and neck surgery patients are better managed on separate wards. If this is not possible, extra attention should be paid to prevent cross infection. Clinicians must have a low threshold of suspecting relevant microorganisms when other specialty patients are on the same ward.