产妇疤痕整形术后感染相关因素分析及预防对策

Related factors for postoperative infections in puerpera undergoing scar plastic surgery and prevention countermeasures

目的探讨产妇疤痕整形术后感染发生的影响因素,为确保产妇瘢痕整形术后安全提供预防控制策略。方法回顾性分析医院2012年2月-2017年2月行疤痕整形术产妇的临床资料,对产妇疤痕整形术后感染发生的影响因素进行单因素及多因素logistic回归分析,采集感染产妇脓性分泌物等临床标本进行病原学检查。结果 3000例疤痕整形产妇术后发生感染35例,感染率为1.17%;共检出病原菌42株,其中铜绿假单胞菌18株,占42.86%;金黄色葡萄球菌9株,占21.43%;多因素Logistic回归分析结果显示,抗菌药物、手术时间、备皮时间、住院时间、残余创面及手术区内残留瘢痕组织为疤痕整形术后发生感染的独立影响因素。结论瘢痕整形术后感染影响因素较多,为减少整形术后感染的发生,临床医师需合理选择抗菌药物,做好术前准备,提高手术成功率,同时加强产妇产后营养,加速其术后康复,缩短疤痕整形术后住院时间。

OBJECTIVE To explore the influencing factors for postoperative infections in puerpera undergoing scar plastic surgery so as to put forward the prevention and control strategies.METHODS The clinical data of puerpera who underwent the scar plastic surgery from Feb 2012 to Feb 2017 were retrospectively analyzed,the univariate analysis and multivariate logistic regression analysis were performed for the influencing factors for the postoperative infections,and the etiological examination was carried out for the clinical specimens such as purulent secretions that were collected from the puerpera with the infections.RESULTS Of 3000 puerpera who underwent the scar plastic surgery,35 has postoperative infections,with the infection rate 1.17%.A total of 42 strains of pathogens were isolated,18（42.86%）of which were Pseudomonas aeruginosa,and 9（21.43%）were Staphylococcus aureus.The result of multivariate logistic regression analysis indicated that the independent influencing factors for the postoperative infection included the use of antibiotics,operation duration,time of skin preparation,length of hospital stay,residual scar tissue and residual scar tissue in surgical sites.CONCLUSIONThere are a variety of influencing factors for the postoperative infections in the puerpera undergoing the scar plastic surgery.Itisnecessary for clinicians to reasonably choose antibiotics,make good preoperative preparation,raise the success rate of surgery,strengthen postpartum nutrition,accelerate the postoperative rehabilitation,and shorten length of hospital stay so as to reduce the incidence of the postoperative infections.