三种常规消毒换药方法对骨科Ⅰ类切口杀菌效果的比较

The Bactericidal Effect of Three Routine Disinfection and Dressing Change Methods on Type Ⅰ Incision in Orthopedic Surgery

目的:探索临床针对骨科Ⅰ类手术切口的有效消毒换药方式,以便为此类型患者术后消毒换药提供参考和借鉴依据。方法:选取2015年8月～2017年8月我院收治Ⅰ类手术患者189例,随机分为酒精消毒组、碘伏消毒组和碘伏消毒覆盖组3组,以不良反应发生率、杀菌率、临床疗效和治疗费用为观察指标。结果:酒精消毒组刺激性疼痛发生率明显高于其他两组,碘伏消毒覆盖组脱皮现象发生率明显高于其它两组,差异均有统计学意义(均P<0.05);3组消毒方式的杀菌率随换药时间延长逐渐减弱,碘伏消毒覆盖组杀菌率明显高于其它两组,差异有统计学意义(P<0.05);3种换药方式的手术切口均于2周内愈合,差异无统计学意义(P>0.05);3组治疗时间和治疗费用相比均无统计学意义(P>0.05)。结论:对于骨科Ⅰ类切口消毒换药的患者,行碘伏消毒覆盖可以有效消减细菌数量,预防因表面细菌残留引起的术后伤口感染。

Objective:To explore the effective disinfection and dressing change methods for orthopedic patients with TypeⅠincision,and provide reference for postoperative disinfection and dressing change of orthopedic patients.Methods:189 cases of TypeⅠoperation were selected in our hospital during August 2015 to August2017.The patients were randomly divided into three groups:alcohol disinfection group,iodophor disinfection group and iodophor disinfection covering group.The incidence of adverse reactions,bactericidal rate,clinical efficacy and treatment cost were measured as indicators.Results:The incidence of irritant pain was higher in the alcohol disinfection group,while the incidence of peeling was higher in iodophor disinfection covering group than that of the other two groups,which were all with statistical difference(all P<0.05).In addition,the bactericidal rate of three groups decreased with the prolongation of dressing change time.The iodophor disinfection covering group had a higher bactericidal rate than the other two groups with a statistical significance(P<0.05).The three methods of disinfection and dressing change could heal incision within 2 weeks,which was without statistical difference(P>0.05).What’s more,there was no significant difference in treatment time and treatment cost among the three groups(P>0.05).Conclusion:The iodophor disinfection covering can effectively reduce the number of bacteria and prevent infection caused by surface bacteria residue after operation in orthopedic patients with TypeⅠincision.