A clinical audit of surgical site infection surveillance in a maxillo-facial and oral surgery unit in an academic hospital complex in South Africa

Abstract

The clinical outcomes and financial impact of surgical site infection within South Africa is not well known due to the lack of an established national surveillance programme. The aim of this project was to undertake a baseline clinical audit of surgical site infection prevention in a Maxillo-facial and Oral Surgery unit using the National Institute for Health and Care Excellence clinical guideline (NG125) as the benchmark standard. The primary objective was to establish a baseline incidence of surgical site infection. This was a prospective and observational clinical audit undertaken at the MFOS unit in a University Hospital in South Africa. Thirty-seven participants who had surgical procedures were recruited and monitored telephonically post-discharge for a period of 30 days. The composite compliance rate to the process indicators was 39.86% (95% Confidence Interval 37.25–42.46). The incidence rate of surgical site infection was 14.81% (n = 8). The resection of head and neck malignancy contributed majority of the SSI cases (50%, n = 4). Five organ/space SSI cases were detected with a mortality rate of 25% (n = 2). The higher surgical site infection rates may be associated with the lapses in the infection control practices. For example, the lack of an aseptic technique lack or structured approach to wound management. The main recommendation was the development of evidence-based surgical site infection preventative strategies that are applicable to the Maxillo-facial and Oral Surgery procedures to reduce surgical site infection.