急诊开放性手外伤术后感染的预防及控制

Prevention and control of postoperative infection after emergency open hand injury

目的 探讨开放性手外伤术后感染的控制及预防措施,为临床提供一定参考依据.方法 2013年8月-2015年7月,从施行手术的开放性手外伤患者中随机选取400例（2014年9月本院对急诊外科人员进行了手外伤处置的学习和规范化培训）,将培训前的200例作为对照组,培训后的200例作为实验组.对照组实施常规的清创消毒等处理措施,实验组实施全面的术前预防、术中彻底清创和术后预防控制措施,对比两组的术后感染率.结果 实验组中13例发生术后感染,感染率为6.5％,对照组中45例发生术后感染,感染率为22.5％,两组差异显著具有统计学意义（P＜0.05）.结论 全面实施规范化的术前预防、术中彻底清创和术后预防控制措施,可有效降低开放性手外伤患者术后感染的发生率,值得临床推广.

Objective To discuss control and prevention of postoperative infection, after open hand injury provide a reference for clinical practice. Methods From my hospital emergency operation of open hand trauma patients between August 2013 and July 2015 randomly selected 400 cases, in September 2014 Emergency Department conducted a study of hand injuries disposal and standardized training, 200 cases befor training as the control group, 200 cases after training as the experimental group. For patients in the control group conventional debridement and disinfection treatment measures were implemental, the experimental group of patients were implemented comprehensive prevention preoperative, intraoperative and postoperative debridement prevention and control measures, compared two groups of patients with postoperative infection. Results In experimental group postoperative infection occurred in 13 cases, the infection rate was 6.5% in the control group, 45 cases occurred in patients with postoperative infection, the infection rate was 22.5%, a significant difference was statistically significant （P 〈0.05）. Conclusion Preoperative comprehensive implementation of standardized prevention, intraoperative and postoperative debridement prevention and control measures can effectively reduce the incidence of postoperative infection caused by open of hand trauma, is worthy of popularization.