Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE (Open Access)

Postoperative infection rates in foot and ankle surgery: a clinical audit of Australian podiatric surgeons, January to December 2007

Paul Butterworth A D , Mark F. Gilheany B and Paul Tinley C
+ Author Affiliations
- Author Affiliations

A La Trobe University Podiatry Clinic, Kingsbury Drive, Bundoora, VIC 3086, Australia.

B East Melbourne Podiatry, Suite 4, 2nd floor Landsdowne House, 182–184 Victoria Parade, East Melbourne, VIC 3004, Australia. Email: mgpod@alphalink.com.au

C School of Community Health, Faculty of Science, Charles Sturt University, PO Box 789, Albury, NSW 2640, Australia. Email: ptinley@csu.edu.au

D Corresponding author. Email: butters05@yahoo.com.au

Australian Health Review 34(2) 180-185 https://doi.org/10.1071/AH08687
Submitted: 1 September 2008  Accepted: 25 November 2009   Published: 25 May 2010

Abstract

Background. Surgical site infections are one of the most common post-operative complications encountered by foot and ankle surgeons. The incidence reported in the literature varies between 0.5 and 6.5%. The results of a 12-month Australia-wide clinical audit analysing the rates of postoperative infections in association with podiatric surgery are presented.

Methods. De-identified patient data was collected from nine podiatric surgeons Australia-wide. Infections were identified according to Australian Council on Health Care Standards (ACHS) definitions and data was entered no earlier than thirty days post procedure.

Results. A total of 1339 patient admissions and 2387 surgical procedures were reported using the International Classification of Diseases (ICD-10) and Medicare Benefit Schedule (MBS) coding systems. The overall infection rate was 3.1% and the rate of infection resulting in hospital re-admission was 0.25%.

Conclusions. The benchmark results presented in this paper suggest that infection rates associated with podiatric surgery are well within accepted industry standards as stated in recent literature.

What is known about the topic? The rates of infection in foot and ankle surgery have been reported in international literature to vary between 0.5 and 6.5%. No such data has been published to date, which describes the rate of infection following podiatric surgery in Australia.

What does this paper add? This paper provides benchmark data on complication rates associated with Australian podiatric surgeons. Such data also informs health and hospital managers who may be considering podiatric surgery as an option for providing foot surgery services within the public hospital system.

What are the implications for practitioners? This paper challenges podiatric surgeons to consider their own practice and whether it is a reflection of best practice.


Acknowledgements

We acknowledge the ACPS and its members for participating in this study. We gratefully acknowledge the surgeons that participated in data collection. We also acknowledge Curtin University for their involvement. The decision to submit the manuscript for publication was made by P. Butterworth and M. Gilheany.


References


[1] Krantz JG. A sensible approach to early postoperative foot infection in the otherwise healthy patient. Clin Podiatr Med Surg 1991; 8 341–57.
PubMed |  CAS | [verified May 1998].

[7] Perencevich EN,  Sands KE,  Cosgrove SE,  Guadagnoli E,  Meara E,  Platt R. Health and economic impact of surgical site infections diagnosed after hospital discharge. Emerg Infect Dis 2003; 9(2): 196–203.
PubMed | [verified July 2003].

[10] Bellotti E. Surveillance of podiatric surgery – hospital report. South Perth Hospital, WA: March; 2005.

[11] Australian Council on Healthcare Standards. Clinical Indicator Program Information; 2009. Available at http://www.achs.org.au/pdf/ACHSClinicalIndicatorProgramInformation2009.pdf [verified 18 April 2010].

[12] Hugar DW,  Newman PS,  Hugar RW,  Spencer RB,  Salvino K. Incidence of postoperative infections in a free standing ambulatory surgery centre. J Foot Surg 1990; 29 265–7.
CAS | PubMed | [verified April 2001].

[21] Platt R,  Deborah SY,  Sands KE. Automated methods for surveillance of surgical site infections. Emerg Infect Dis 2001; 7(2): 212–6.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |

[22] Surgical Audit Taskforce RACS . Surgical Audit and Peer Review. The Professional Development and Standards Board, Royal Australian College of Surgeons, 2005.

[23] Watters DAK,  Green AJ,  van Rij A. Guidelines for surgical audit in Australia and New Zealand. ANZ J Surg 2006; 76 78–83.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[24] French GL. Closing the loop: Audit in infection control. J Hosp Infect 1993; 24(4): 301–8.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |

[25] Van Essen A , Gilheany M. Podiatric surgery and healthcare reform-Response to the productivity commission’s report into the Australian healthcare workforce. Australasian College of Podiatric Surgeons. October 2006. pp. 17–19. [Draft]

[26] Butterworth P , Tinley P. Post-operative infection rates in podiatric surgical practice: a review of the literature. Australas J Podiatr Surg 2007; 41(3): 39–43. Abstract available at http://www.apodc.com.au/AJPM/Contents/volume_413.htm

[27] Bennett PJ. Prevalence and type of foot surgery performed in Australia: A clinical review. Foot 2007; 17(4): 197–204.
Crossref | GoogleScholarGoogle Scholar |

[28] Jutley RS,  McKinley A,  Hobeldin M,  Mohamed A,  Youngson GG. Use of clinical audit for revalidation: is it sufficiently accurate? J Qual Clin Pract 2001; 21(3): 71–3.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |

[29] Sherertz RJ,  Garibaldi RA,  Marosok RD. Consensus paper on the surveillance of surgical site infections. Am J Infect Control 1992; 20 263–70.
Crossref | GoogleScholarGoogle Scholar |