Graft infection rates following vascular surgery have been significantly improved at the Leicester Royal Infirmary through a raft of changes at the Trust. As an unexpected consequence, antibiotic costs have been halved. LOUISE FRAMPTON reports.
In its last annual report, the University Hospitals of Leicester NHS Trust reported that it reduced the number of cases of MRSA by 55% and the number of C. difficile cases by 64%, over the period of 2007/08. Significant progress has also been achieved in relation to reducing SSIs – notably in patients on the vascular ward of the Leicester Royal Infirmary (LRI) where the surgical team has proven to be a driving force for change. At a symposium on SSIs, in Birmingham, Professor Naylor, consultant vascular surgeon, LRI, explained why vascular patients are prone to SSIs and gave an insight into how infection risks can be minimised in a vascular ward area. He pointed out that, although the majority of arterial procedures are classed as “clean”, patients are often elderly, there is a prolonged length of hospital stay and diabetes is relatively common in this patient group, which increases susceptibility to infection. Other risk factors include:
• Steroid therapy.
• Use of prosthetic materials.
• Prololonged operation times and associated hypothermia.
• Post-operative soft tissue oedema, reperfusion oedema.
• Post-operative haematomas.
• Perioperative heparin/antiplatelet therapy.
• Open wounds/crticial ischaemia.
• Renal impairment.
• Use of groin incisions.
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