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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 9, 1267-1271.
doi: 10.1302/0301-620X.87B9.16672  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Superficial incisional infection in arthroplasty of the lower limb

INTEROBSERVER RELIABILITY OF THE CURRENT DIAGNOSTIC CRITERIA

M. K. Allami, FRCS, Specialist Registrar1; W. Jamil, MBChB, BSc, Senior House Officer2; B. Fourie, FRCS, Specialist Registrar3; V. Ashton, BSc, MSc, Lecturer in Medical Statistics4; and P. J. Gregg, FRCS, Consultant Orthopaedic Surgeon, Professor of Orthopaedic Surgical Science5

1 7 Allerton Grange Crescent, Leeds, LS17 6LN, UK.
2 Trauma and Orthopaedics, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK.
3 Trauma and Orthopaedics
4 School of Health and Social Care, Parkside West Offices (2nd Floor) Teesside University, Park Road North, Middlesbrough TS1 3LF, UK.
5 Orthopaedic Department, James Cook University Hospital, Middlesbrough TS5 5AZ, UK.

Correspondence should be sent to Mr. M. K. Allami; e-mail: mklami{at}yahoo.com

The Department of Health and the Public Health Laboratory Service established the Nosocomial Infection National Surveillance Scheme in order to standardise the collection of information about infections acquired in hospital in the United Kingdom and provide national data with which hospitals could measure their own performance. The definition of superficial incisional infection (skin and subcutaneous tissue), set by the Center for Disease Control (CDC), should meet at least one of the defined criteria which would confirm the diagnosis and determine the need for specific treatment.

We have assessed the interobserver reliability of the criteria for superficial incisional infection set by the CDC in our current practice. The incisional site of 50 patients who had an elective primary arthroplasty of the hip or knee was evaluated independently by two orthopaedic clinical research fellows and two orthopaedic ward sisters for the presence or absence of surgical-site infection. Interobserver reliability was assessed by comparison of the criteria for wound infection used by the four observers using kappa reliability coefficients. Our study demonstrated that some of the components of the current CDC criteria were unreliable and we recommend their revision.




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(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General