• Blackpool Teaching Hospitals Foundation Trust and Salford Royal FT had the highest SSI rates in orthopaedics
  • Blackpool spokeswoman says trust carried out “thorough investigations” into all SSIs
  • Salford says some of its higher rates were likely down to its trauma centre status

Two teaching hospital trusts are the main outliers for orthopaedic surgical site infections nationally, new data has revealed. 

Public Health England data on infections picked up during or immediately after surgery revealed Blackpool Teaching Hospitals Foundation Trust and Salford Royal FT had the highest rates in orthopaedics in 2017-18.

The data, released in December by the Department of Health and Social Care, showed eight infections among Blackpool’s 360 repair of fractured neck of femur procedure patients.

Meanwhile, seven of Salford Royal’s 317 reduction of long bone fracture patients got an SSI during 2017-18.

Other trusts had higher infection rates but these were on small numbers of procedures.

A Blackpool spokeswoman said the trust carried out “thorough investigations” into all SSIs and “no obvious common source has been found”.

She said in a statement: “We developed an action plan to address possible causes which is still ongoing. Such actions included standardisation of surgical skin preparation and the introduction of a tamperproof dressing which has led to a significant reduction in our infection rates.”

Salford said some of its higher rates were likely down to its status as a trauma centre, accepting more complex cases from across Greater Manchester.

Pete Turkington, medical director of Salford Royal, said: “We take surgical site infection very seriously and employ a dedicated surgical site surveillance team with robust systems in place to identify and monitor patients as inpatients, post discharge and on readmission.

“Salford Royal is Greater Manchester’s principal receiving site for major trauma meaning the trust predominantly deals with emergency reduction of long bone fracture, where incidence of infection can be higher than elective surgery.

“Each infection is subject to an indepth root cause analysis, which investigates practices in key areas such as theatres, wound care, skin prep and compliance with the WHO safer surgery checklist.

“Where potential trends or areas for improvement are identified, governance processes are in place to address learning and implement policy change where necessary.”

Submitting data on SSIs for orthopaedics has been mandatory since 2004 and it is one of the lowest SSI categories for surgery, with large bowel surgery the highest risk.

Dr Theresa Lamagni, senior epidemiologist at Public Health England, said: ”Surgical site infections can be a serious consequence of undergoing surgery. While infections after hip and knee replacements have fallen over the last year, there has been a small rise in infections following bowel surgery. We continue to work with our colleagues across the NHS and Department of Health and Social Care to support hospitals in their efforts to keep infections at the lowest levels possible.

”Antibiotics are commonly used prior to surgery and this intervention plays an important role in preventing infections. Monitoring the types of bacteria causing surgical site infections helps hospitals ensure they use the right antibiotics to prevent infection. This is particularly important in light of the rise in antibiotic resistance.”