普外科患者不同备皮方法对术后感染的影响研究

Influence of different skin preparation methods on postoperative infections in patients of general surgery department

目的探讨不同备皮方法对普外科手术患者术后感染发生率的影响,为普外科术前备皮选择较好的方法,以保证患者手术安全。方法选取2011年3月-2013年12月普外科手术患者549例,随机分为A组270例给予常规备皮,剔除手术视野内所有毛发;B组279例在备皮过程中不剔除毛发,而仅进行皮肤清洁;对伤口愈合进行统计,数据采用SPSS 13.0软件进行分析。结果 A组患者手术切口发生表浅感染和深部感染率分别为4.07%和0.74%,B组患者分别为6.09%和1.79%、B组患者发生切口感染率高于A组,两组比较差异有统计学意义(P<0.05);Ⅰ类切口A组患者全部达到甲级愈合、B组患者甲级愈合率为95.83%;Ⅱ类切口A组患者甲级和乙级愈合率分别为97.74%和2.26%、B组患者分别为96.17%和3.28%,两组比较差异均无统计学意义。结论对于普外科手术患者应根据切口类型分别采取不同的备皮方式,Ⅰ类和Ⅱ类切口可以不剔除毛发,而直接进行有效的清洁和消毒;而对于Ⅲ类切口,则应先剔除毛发,然后再对皮肤进行清洁消毒,由此通过个体化的备皮方式在保证患者手术安全的前提下,尽量提高患者的舒适度,并减少护理人员的工作量。

OBJECTIVE To observe the influence of different skin preparation methods on incidence of postoperative infections in patients of general surgery department and choose the appropriate skin preparation method so as to ensure the surgical safety of the patients .METHODS A total of 549 patients who underwent surgeries in the gen‐eral surgery department from Mar 2011 to Dec 2013 were enrolled in the study and randomly divided into the group A with 270 cases and the group B with 279 cases .The group A was treated with conventional skin preparation , while the group B was only treated with skin cleaning without removing hair during the skin preparation .The wound healing was taken for statistics ,and the statistical analysis of data was performed with the use of SPSS 13 .0 software .RESULTS The incidence of superficial incision infections was 4 .07% in the group A ,6 .09% in the group B;the incidence of deep incision infections was 0 .74% in the group A ,1 .79% in the group B;the incidence of incision infections was higher in the group B than in the group A ,and the difference was significant （P〈0 .05） . All the patients with type Ⅰ incision of the group A achieved the grade A wound healing ,and 95 .83% of the pa‐tients achieved the grade A wound healing in the group B .The rate of grade A wound healing of the patients with type Ⅱ incision was 97 .74% in the group A ,96 .17% in the group B ;the rate of grade B wound healing of the pa‐tients with type Ⅱ incision was 2 .26% in the group A ,3 .28% in the group B ,and there was no significant differ‐ence between the two groups .CONCLUSION It is necessary to take the appropriate skin preparation method ac‐cording to the types of incision and directly conduct the effective cleaning and disinfection without removing the hair for the type Ⅰ and Ⅱ incision surgery .However ,it is necessary for the type Ⅲ incision surgery to firstly re‐move the hair and then clean and disinfect the skin .On the premise of ensuring the surgical safety through the in‐dividualized skin preparation method ,the comforts of the patients should be improved ,and the workload of the nursing staff should be reduced .