骨科手术部位感染危险因素分析及微信随访探讨

Analysis on risk factors of orthopedic surgical site infection and the investigation of Wechat follow-up

目的研究骨科手术切口感染发生的相关高危因素，探讨微信随访在术后出院应用，为降低骨科手术出院后切口感染的发生提供对策。方法选取2016年1月至12月1453例骨科手术患者进行回顾性调查，分析住院期间和出院后引起手术感染的相关因素。结果1453例骨科手术患者中，住院期间发生手术切口感染26例，感染率为1．79％；1427例住院期间未发生切口感染的患者，出院后发生8例切口感染，感染率为0．56％。手术切口感染病例中，年龄、基础疾病、手术时间、植入物情况、出院时切口情况及随访情况的差异有统计学意义（P〈0．05）。结论引起骨科手术感染的发生与多种因素相关。住院期间，应严格落实术前评估与准备、术中无菌操作及组织保护、术后无菌换药；出院后，可在电话随访的基础上增加微信随访，以期在提高随访率的同时，增加术后护理知识的掌握，减少手术部位感染。

Objective To analyze the related risk factors of the orthopedic surgical site infection and investigate application of Wechat follow-up so as to provide reference for reducing infection after orthopedic surgery. Method A total of 1 453 patients with orthopedic surgery from Jan. 2016 to Dec. 2016 were selected and retrospectively analyzed the related risk factors of the orthopedic surgical site infection at the time of hospitalization and post-discharge. Results Among 1 453 patients with orthopedic surgery, there were 26 cases of surgical site infection, accounting for 1.79%; the surgical site infection occurred in 8 of 1 427 patients after discharge, accounting for 0.56%. Age, basic disease, the time of operation, implant situation, incision situation at discharge, and follow-up visit were the factors that might cause orthopedic surgical site infection, with statistically significant differences （P〈0.05）. Conclusions There are many factors that are related to the orthopedic surgical site infection, thus it is necessary to implement strictly the preoperative evaluation and preparation, intraoperative sterile operation and tissue protection, postoperative aseptic dressing during hospitalization. After the discharge, we should add Wechat follow-up on the basis of telephone follow-up, it can increase the knowledge of postoperative care to reduce the surgical site infection.