Editor—The data presented before 1998 were for MRSA infections alone. In the same graph we showed a rise in the number of infections with methicillin resistant Staphylococcus aureus (MRSA) on wards where patients undergoing elective orthopaedic operations were nursed after the move to the district general hospital. At this point patients were mixed together with patients with trauma and patients from other specialties. This was the trigger for setting up the prospective trial.
The study showed that a ring fenced ward (or stand alone unit in a district general hospital), along with simple infection control measures, significantly reduced all infections and the MRSA infection rate after elective arthroplasty was zero.
Our study was not set up to comment on stand alone units, and the data collected cannot be extrapolated to do so.
Competing interests: None declared.