509. Wound Infection Surveillance of War Wounds in British Forces Personnel
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Data on war wound infection is difficult to establish with retrospective collection and confusion with wound colonization. Deployed British military personnel sustaining battlefield wounds enter a single aeromedical evacuation pathway with rapid repatriation to a sole UK civilian hospital in Birmingham. To identify true clinical wound infection in these patients a purpose designed prospective wound infection surveillance system (WISS) was established.
Methods: All military patients admitted to the UK civilian hospital with battlefield wounds were included and followed up until hospital discharge. Wounds were clinically and objectively assessed for infection using Surgical Site Infection Surveillance, UK definitions. Mechanism and pattern of injury sustained, surgical interventions, patient clinical condition, laboratory infection parameters, antimicrobial history and microbiology findings were also recorded.
Results: In the twelve month, period (April 2008 - April 2009) 162 patients were captured by WISS. 36 distinct wound infection episodes occurred in 27 individuals, a wound infection rate of 16%. 75% of these were classified as deep infections. All were contaminated at time of injury, most often (88%) blast injury. No deaths resulted from wound infection. Microbiology varied but Acinetobacter Spp caused no clinical infections despite significant rates (37%) of colonisation.
Conclusions: WISS is an excellent purpose designed tool for prospective clinical wound infection surveillance of battlefield injuries. The low clinical wound infection rate reflects the quality of primary surgical care delivered. The results are a critical performance indicator of surgical and post trauma care forming an integral part of patient management. WISS will now be extended to include long term follow up.
Andrew Green, MD, Defence Medical Services Departmen, MOD, London, United Kingdom, Deborah Mortiboy, MD, Department of Microbiology, Queen Elizabeth Medical Centre, University Hospital Birmingham, Birmingham, United Kingdom, Tania Thomas, RGN, MSc, Royal Centre of Defence Medicine, Birmingam, United Kingdom and  T. M. Thomas, None..
D. Mortiboy, None..
A. D. Green, None.