骨科Ⅰ类切口手术感染的原因探讨

Causes of Infection in the Orthopedic Patients with TypeⅠ Incision

目的:探讨骨科Ⅰ类手术切口感染原因以及预防控制感染的可执行力。方法:采集骨科Ⅰ类手术有内置器材的病例资料4079份。根据患者手术相关资料、围手术期抗菌药物的使用情况进行合理性评价以及术后切口感染的比较并进行统计分析。结果:术后1个月内出现感染症状的病例占79.2%;足部位感染占29.2%,腰膝部位各占25%;深部感染率达到50%,腔隙感染率占37.5%;金黄色葡萄球菌感染率达到37.5%,耐药金黄色葡萄球菌感染率占16.7%、围手术期用药选择不合理占50%,用药时间不合理占66.7%;结论:预防骨科手术部位感染的三个关键点即无菌技术操作;改善手术技巧;围手术期合理使用抗菌药物;依法管理、科学防控、关键在行动。

Objective：To explore the causes of infection in the orthopedic patients with typeⅠ incision,and to detect the effective execution method of the infection prevention and control.Methods：All 4079 cases of orthopedic patients with typeⅠ incision and internal fixation were collected.The evaluation of the operative related information and the antibiotics used in peroperative period,as well as the infective information were analyzed statistically.Results：One month after operation,the total infection rate was 79.2%.The foot infection rate was 29.2%,waist and knees was 25% respectively,deep infection rate was reached 50%,lacuna infection rate was 37.5%,staphylococcus aureus infection rate was 37.5%,and drug-resistant staphylococcus aureus infection rate was 16.7% during peroperative period.The rate of unreasonable use of antibiotics was 50%,while,the rate of unreasonable time of treatment was 66.7%.Conclusion：The aseptic technique,improved surgical skills,and rational use of antibiotics during peroperative period are three main keys to prevent infection of orthopedic surgery site.And action is the key of the management according to law and scientific prevention and control.