Perineal hygiene in patients with pelvic fractures

SummaryAt the tertiary referral Orthopaedic Unit of St. Georges Hospital, it was noted that there was an unacceptably high number of soiled perinea in patients transferred from Base Hospitals. This not only exposed the patients to increased infection1 and 2 but was also undignified and unacceptable for them. We decided to audit the problem with a view to finding out why this was happening and to improve the situation.A 2-year study was carried out over three distinct phases (phase 1: February–June 2004, phase 2: July–November 2004, phase 3: February–November 2005). Observations of soiling were recorded in a questionnaire by the surgeon prior to surgery. Key system and clinical guidelines were implemented during the second phase, and the audit process was repeated.The percentage of clean perinea in phase 1 was 32%, phase 2 68% and phase 3 99.5% indicating a clear improvement in the overall system.