Post-discharge surveillance of surgical site infection is necessary if accurate rates of infection following surgery are to be available. We undertook a prospective study of 376 knee and hip replacements in 366 patients in order to estimate the rate of orthopaedic surgical site infection in the community. The inpatient infection was 3.1% and the post-discharge infection rate was 2.1%. We concluded that the use of telephone interviews of patients to identify the group at highest risk of having a surgical site infection (those who think they have an infection) with rapid follow-up by a professional trained to diagnose infection according to agreed criteria is an effective method of identifying infection after discharge from hospital.

The scalpel blades used during 187 operations were cultured. At each procedure the knife used to incise the skin was discarded immediately and a fresh knife was used to complete the operation. The results showed that there was no difference in the bacterial growth between the two knives. From these results it would appear that the practice of changing blades after incising the skin is an unnecessary precaution in the prevention of bacterial contamination of clean wounds.

Between 1959 and 1974 the late Dillwyn Evans treated severe symptomatic flat feet by elongating the os calcis. The long-term follow-up of 20 of these patients with a total of 23 feet is presented 7 to 20 years after the operation. At review 17 of the 23 feet showed very good or good results and it was concluded that this is a useful procedure for severe cases of flat feet which appears to stand the test of time.