Effect of weight-adjusted antimicrobial antibiotic prophylaxis on postoperative dosage and surgical site infection incidence in total joint arthroplasty

Surgical site infections(SSI)following total joint arthroplasty pose a significant concern for both providers and patients across the globe.Currently,administration of antimicrobial antibiotic prophylaxis is used throughout the world to reduce the incidence of SSI.However,the correct dosage and frequency of administration remains debatable.In this editorial,we emphasized the determination of the effect of administration of weight-adjusted antimicrobial antibiotic prophylaxis regime on the incidence of SSI and postoperative dosage reduction compared to the conventionally used regime during total joint arthroplasty.The results demonstrated similar efficacy between both regimes with respect to the incidence of SSI.In addition,weight-adjustment led to reduced postoperative dosage and has the potential to reduce chances of achieving lower therapeutic concentration,drug resistance,drug toxicity,and costs.

Vancomycin lavage for the incidence of acute surgical site infection following primary total hip arthroplasty and total knee arthroplasty

BACKGROUND Surgical site infection is a rare but serious complication associated with total joint arthroplasty(TJA).There are limited data on the effectiveness of intrawound irrigation with vancomycin solution(1000 mg/L;2 L)before wound closure for preventing acute surgical site infection following primary total hip arthroplasty(THA)and total knee arthroplasty(TKA).AIM To investigate the effectiveness of prophylactic intraoperative application of vancomycin(1000 mg/L;2 L)solution vs.plain irrigation in reducing the incidence of acute surgical site infection following primary THA and TKA.METHODS A retrospective review of 2725 consecutive patients undergoing THA or TKA from January 2012–December 2019 was performed.These patients received either intrawound irrigation with normal saline before wound closure between January 2012 and December 2015(group 1,1018 patients;453 undergoing THA and 565 undergoing TKA)or intrawound irrigation with vancomycin solution(1000 mg/L)before wound closure between January 2016 and December 2019(group 2,1175 patients;512 undergoing THA and 663 undergoing TKA).The outcomes were the incidences of postoperative surgical site infection and wound healing complications within 3 mo of primary TJA.RESULTS There were no significant demographic differences between the 2 groups.There was a significantly higher incidence of acute infection at the surgical site in patients who received intrawound irrigation with normal saline before wound closure than in those who received intrawound irrigation with vancomycin solution(1000 mg/L;2 L)before wound closure(overall incidence of infection:group 1,2.46%vs group 2,0.09%,P<0.001).There was no significant difference in the incidence of wound healing complications between the two groups.CONCLUSION Prophylactic irrigation with vancomycin solution(1000 mg/L;2 L)significantly decreases the incidence of acute surgical site infection after primary TJA.This strategy is a safe,efficacious,and inexpensive method for reducing the incidence of acute surgical site infection after TJA.

Risk Factors for Surgical Site Infection after Hip Arthroplasty: A Multicentric Study

The objective of this study is to answer three main questions: What is the risk of wound infection for patients undergoing hip arthroplasty? What are the main etiologicagents of surgical site infection (SSI)? What are the risk factors most associated with surgical site infection? Method: This was a multicentric, retrospective cohort study which analyzed data collected in five general hospitals in Belo Horizonte, Brazil, between the period of January 2009 and December 2013. The continuous parameters studied were age, length of hospital stay before surgery, duration of surgery, number of professionals at surgery and number of hospital admissions. Categorical variables were surgical wound classification (clean, clean contaminated, contaminated, dirty/infected), American Society of Anesthesiologists (ASA) score (I, II, III, IV, V), type of surgery (elective, emergency), general anesthesia (yes, no), prophylactic antibiotic (yes, no), trauma surgery (yes, no) and Nosocomial Infections Surveillance (NNIS) risk index (IRIC = 0, 1, 2, 3). Results: Estimated SSI risk was 3.2% (95% C.I. = 2.6% to 4.1%) and risk of osteomyelitis was 0.6% (95% C.I. = 0.4% to 1.1%). ASA score > 2, general anesthesia, length of hospital stay before surgery higher than four days, more than two professionals at surgical field and duration of surgery higher than five hours were risk factors for SSI after hip prosthesis (p < 0.05). The final multiple logistic regression analysis indicated that the modified NNIS risk was independently associated with surgical site infection after arthroplasty of hip. Conclusion: Despite the modified NNIS index being a risk factor for SSI, none of its independent variables was statistically significantly in the logistic model (p > 0.100). Each modified NNIS risk category increased the chance of a patient being infected by almost three times, when compared with the previous category (OR = 2.82;p = 0.011).

Assessment of the effectiveness of weight-adjusted antibiotic administration,for reduced duration,in surgical prophylaxis of primary hip and knee arthroplasty

BACKGROUND Prophylactic antibiotics have significantly led to a reduction in the risk of postoperative surgical site infections(SSI)in orthopaedic surgery.The aim of using antibiotics for this purpose is to achieve serum and tissue drug levels that exceed,for the duration of the operation,the minimum inhibitory concentration of the likely organisms that are encountered.Prophylactic antibiotics reduce the rate of SSIs in lower limb arthroplasty from between 4%and 8%to between 1%and 3%.Controversy,however,still surrounds the optimal frequency and dosing of antibiotic administration.AIM To evaluate the impact of introduction of a weight-adjusted antibiotic prophylaxis regime,combined with a reduction in the duration of administration of post-operative antibiotics on SSI incidence during the 2 years following primary elective total hip and knee arthroplasty METHODS Following ethical approval,patients undergoing primary total hip arthroplasty(THA)/total knee arthroplasty(TKA)with the old regime(OR)of a preoperative dose[cefazolin 2 g intravenously(IV)],and two subsequent doses(2 h and 8 h),were compared to those after a change to a new regime(NR)of a weight-adjusted preoperative dose(cefazolin 2 g IV for patients<120 kg;cefazolin 3g IV for patients>120 kg)and a post-operative dose at 2 h.The primary outcome in both groups was SSI rates during the 2 years post-operatively.RESULTS A total of n=1273 operations(THA n=534,TKA n=739)were performed in n=1264 patients.There was no statistically significant difference in the rate of deep(OR 0.74%(5/675)vs NR 0.50%(3/598);fishers exact test P=0.72),nor superficial SSIs(OR 2.07%(14/675)vs NR 1.50%(9/598);chi-squared test P=0.44)at 2 years postoperatively.With propensity score weighting and an interrupted time series analysis,there was also no difference in SSI rates between both groups[RR 0.88(95%CI 0.61 to 1.30)P=0.46].CONCLUSION A weight-adjusted regime,with a reduction in number of post-operative doses had no adverse impact on SSI incidence in this population.

Preventing surgical site infection using operating room bundle of care in patients undergoing elective exploratory laparotomy cholecystectomy surgery

Objective:Surgical procedures manifest immense risks to patients.One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical site infection(SSI).Although several effor ts are being under taken to determine the proper means to reduce such complications,there is still a high incidence of SSI worldwide.Surgery requires knowledge in infection control and high precision in maintaining a clean surgical site.This study tested the effectiveness of an operating room(OR)bundle of care in preventing SSI in patients undergoing elective exploratory laparotomy cholecystectomy surgery.Methods:A quasi-experimental pretest and posttest design was utilized to determine its effectiveness.The study was composed of 60 par ticipants divided into two groups:30 subjects were selected to receive the OR bundle of care,while the other 30 subjects received the usual care.The groupings were determined through a systematic random sampling technique.The OR bundle of care had three interventions,namely:(1)maintaining perioperative normothermia,(2)no pre-operative surgical site hair removal,and(3)changing gloves before abdominal wall closure.These patients were evaluated using the standard instrument,Bates–Jensen Wound Assessment Tool(BWAT)in the post-intervention phases of the wound healing process,which are as follows:hemostasis,inflammatory,and proliferative phases.To describe the difference in the patients’wound status after implementation of the OR bundle of care in each post-intervention phase,Friedman’s test was used.To describe the difference in the patients’wound status in both groups after implementation of the OR bundle of care,the Mann–Whitney U test was used.Results:The patient’s wound status was lower,indicating a more healing process.Differences between the wound status of the control and the experimental group were observed on the third postoperative day.This indicates that the experimental group’s wound status healed much faster and more effectively than the control group based on the BWAT scoring severity scoring.A significant difference in the patient’s wound status from the hemostasis phase compared with the proliferative phase was observed.Conclusions:The OR bundle of care has been shown to be effective in preventing SSI in patients who had undergone exploratory laparotomy cholecystectomy surgery in the selected hospital,if there is uniform and consistent implementation of the said intervention.

What Is the Evidence Supporting the Use of Surgical Face Masks in the Operating Room in Preventing Surgical Site Infection after Clean Surgery? A Systematic Review

Background: Facemask is an essential component of the surgical outfit adorned by operating room staff to filter microorganisms by droplets from the oral and nasopharynx of the personnel, thereby reducing contamination, protecting the patient’s wound and minimising the risk of Surgical Site Infections (SSI). Objective: The objective of this review was to explore the available evidence and provide a better understanding of the effect of a surgical facemask in preventing SSI in clean surgery performed in the operating room. Data sources: Key electronic databases related to nursing, allied health, life science, biomedicine and research were searched for published literature on the use of facemask in the operating room. Methodology: A systematic review of quantitative research studies of randomised controlled trials was conducted with a meta-analysis of the results. Results: No variation in the rate of infection between the two (masked and unmasked) groups. Conclusion: The effect of facemask in minimising SSI after clean surgery remains questionable due to the limited results. More comprehensive research is needed.

Risk Factor of Postoperative Lumbar Surgical Site Infection: A Literature Review

Nowadays there have been various advanced techniques to overcome disparate types of lumbar degenerative diseases. However, post-operation complications such as Surgical Site Infection (SSI) still give the surgeon with a big challenge. This article is going to study the risk factor that causes the lumbar SSI by reviewing all the articles that can be assessed through PubMed, websites of science and other internet data base. Numerous articles have stated different reported prevalence rates of 0.7% to 16% for surgical site infection. This article will document the most common and significant risk factors for SSI. At last, we suggest that there should be preoperative patient screening and postoperative internal environment maintenance, this will be the best way to reduce postoperative SSI rate or prevent SSI from happening.

Antibiotic Prescribing Patterns and Prevalence of Surgical Site Infections in Caesarean Section Deliveries at Two Tertiary Hospitals in Lusaka, Zambia

Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.

Influence of staff number and internal constellation on surgical site infection in an operating room

Prediction of bacteria-carrying particle （BCP） dispersion and particle distribution released from staffmem- bers in an operating room （OR） is very important for creating and sustaining a safe indoor environment. Postoperative wound infections cause significant morbidity and mortality, and contribute to increased hospitalization time. Increasing the number of personnel within the OR disrupts the ventilation airflow pattern and causes enhanced contamination risk in the area of an open wound. Whether the amount of staffwithin the OR influences the BCP distribution in the surgical zone has rarely been investigated. This study was conducted to explore the influence of the number of personnel in the OR on the airflow field and the BCP distribution. This was performed by applying a numerical calculation to map the airflow field and Lagrangian particle tracking （LPT） for the BCP phase. The results are reported both for active sampling and passive monitoring approaches. Not surprisingly, a growing trend in the BCP concentration （cfu/ms） was observed as the amount of staff in the OR increased. Passive sampling shows unpredictable results due to the sedimentation rate, especially for small particles （5-10 i^m）. Risk factors for surgical site infections （SSls） must be well understood to develop more effective prevention programs.

Prevention of surgical site infection under different ventilation systems in operating room environment

Biological particles in the operating room(OR)air environment can cause surgical site infections(SSIs).Various ventilation systems have been employed in ORs to ensure an ultraclean environment.However,the effect of different ventilation systems on the control of bacteria-carrying particles(BCPs)released from the surgical staff during surgery is unclear.In this study,the performance of four different ventilation systems(vertical laminar airflow ventilation(VLAF),horizontal laminar airflow ventilation(HLAP),differential vertical airflow ventilation(DVAF),and temperature-controlled airflow ventilation(TAF))used in an OR was evaluated and compared based on the spatial BCP concentration.The airflow field in the OR was solved by the Renormalization Group(RNG)k-e turbulence model,and the BCP phase was calculated by Lagrangian particle tracking(LPT)and the discrete random walk(DRW)model.It was found that the TAF system was the most effective ventilation system among the four ventilation systems for ensuring air cleanliness in the operating area.This study also indicated that air cleanliness in the operating area depended not only on the airflow rate of the ventilation system but also on the airflow distribution,which was greatly affected by obstacles such as surgical lamps and surgical staff.

Use of antibacterial sutures for skin closure in controlling surgical site infections: a systematic review of published randomized, controlled trials

Objective:The objective of this article is to systematically analyse the randomized,controlled trials that compare the use of antibacterial sutures(ABS)for skin closure in controlling surgical site infections.Methods:Randomized,controlled trials on surgical patients comparing the use of ABS for skin closure in controlling the surgical site infections were analysed systematically using RevMan^(■)and combined outcomes were expressed as odds ratios(OR)and standardized mean differences(SMD).Results:Seven randomized,controlled trials evaluating 1631 patients were retrieved from electronic databases.There were 760 patients in the ABS group and 871 patients in the simple suture group.There was moderate heterogeneity among trials(Tau^(2)=0.12;chi^(2)=8.40,df=6[P<0.01];I^(2)=29%).Therefore in the random-effects model,the use of ABS for skin closure in surgical patients was associated with a reduced risk of developing surgical site infections(OR,0.16;95%CI,0.37,0.99;z=2.02;P<0.04)and postoperative complications(OR,0.56;95%CI,0.32,0.98 z=2.04;P=0.04).The durations of operation and lengths of hospital stay were similar following the use of ABS and SS for skin closure in patients undergoing various surgical procedures.Conclusion:Use of ABS for skin closure in surgical patients is effective in reducing the risk of surgical site infection and postoperative complications.ABS is comparable with SS in terms of length of hospital stay and duration of operation.

Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection

Purpose:Antibiotic-loaded bone cement(ALBC)was usually used to prevent periprosthetic joint infection(PJI)in primary total knee arthroplasty(PTKA),but whether to use ALBC or plain bone cement in PTKA remains unclear.We aimed to compare the occurrence rate of PJI using two different cements,and to investigate the efficacy of different antibiotic types and doses administered in preventing surgical site infection(SSI)with ALBC.Methods:The availability of ALBC for preventing PJI was evaluated by using a systematic review and meta-analysis referring to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Existing articles until December 2021 involving PTKA patients with both ALBC and plain bone cement cohorts were scanned by searching"total knee arthroplasty","antibiotic-loaded cement","antibiotic prophylaxis","antibiotic-impregnated cement"and"antibiotic-laden cement"in the database of PubMed/MEDLINE,Embase,Web of Science and the Cochrane Library.Subgroup analysis included the effectiveness of different antibiotic types and doses in preventing SSI with ALBC.The modified Jadad scale was employed to score the qualities of included articles.Results:Eleven quantitative studies were enrolled,including 34,159 knees undergoing PTKA.The meta-analysis results demonstrated that the use of prophylactic ALBC could significantly reduce the prevalence of deep incisional SSI after PTKA,whereas there was no significant reduction in the rate of superficial incisional SSI.Moreover,gentamicin-loaded cement was effective in preventing deep incisional SSI,and the use of high-dose ALBC significantly reduced the rate of deep incisional SSI after PTKA.Besides,no significant adverse reactions and complications were stated during the use of ALBC in PTKA.Conclusion:The preventive application of ALBC during PTKA could reduce the rates of deep PJI.Furthermore,bone cement containing gentamicin and high-dose ALBC could even better prevent deep infection after PTKA.However,the existing related articles are mostly single-center and retrospective studies,and further high-quality ones are needed for confirmation.

造口回纳术后切口感染危险因素分析及预测模型构建

目的研究造口回纳术后切口感染的现状并对危险因素进行探讨,构建风险预测模型。方法本研究为前瞻性队列研究,招募浙江大学医学院附属第一医院2023年9月至2024年2月行造口回纳术的患者为研究对象,随访30 d。采用多因素logistic回归分析造口回纳术后切口感染的影响因素并构建风险预测模型,应用受试者工作特征曲线、Hosmer-Lemeshow检验和列线图分析模型预测价值。结果310例患者中发生造口回纳术后切口感染有83例,手术切口感染的发生率为26.8%。多因素logistic回归分析结果表明,术前造口周围皮炎、造口术后切口感染史、预防性使用抗生素是造口回纳术后切口感染的影响因素(P<0.05);Logit(P)=-0.890+1.676×造口术后切口感染史+1.208×术前造口周围皮炎-0.948×预防性使用抗生素。受试者工作特征曲线下面积为0.730,约登指数0.412,最佳截断值0.247,模型特异度74.9%,敏感度66.3%。Hosmer-Lemeshow检验,P=0.926。结论造口回纳术后切口感染发生率较高,术前造口周围皮炎、造口术后切口感染史、预防性使用抗生素是造口回纳术后切口感染的独立预测因子,基于上述因素构建的预测模型预测效果较好。

洁净手术室空调系统改善措施研究

为了减少手术过程中因空气细菌污染物引起的感染,提高手术成功率,要求通风空调系统要满足合适的手术室温度、湿度,并维持室内外合理的气流流向,从而减少室内细菌的浓度。按目前的研究情况,层流通风系统对降低室内悬浮菌和手术部位感染率是有效的;略高于50%的湿度可抑制细菌的滋生;手术室温度需同时满足医护和患者的需求,各国标准温度范围在19~26℃之间;采用循环风紫外线空气消毒方式显著减少空气中的总颗粒数和活颗粒数,进而降低手术患者的感染率。

肝胆手术手术部位感染相关危险因素研究

目的探讨肝胆手术手术部位感染(surgical site infection,SSI)的危险因素,为制定SSI的控制措施提供依据。方法采用目标性监测的方法,研究肝胆手术SSI的发生情况,并对其相关危险因素:术前住院日、有无糖尿病、外周血血浆清蛋白、手术持续时间、手术方式、ASA评分、切口方向、切口长度、术中失血量、术后引流管留置天数及有无术后并发症等24个变量进行单因素和多因素Logistic回归分析。结果肝胆手术SSI发生率为11.74%(35/298),其中住院期问感染24例(68.57%),出院后随访发现感染11例(31.43%)。Logistic回归分析结果显示,术后出现脂肪液化和切口裂开等并发症、手术持续时间及术后引流天数是SSI的独立危险因素。结论肝胆手术SSI的发生是多因素共同作用的结果,必须采取综合性的预防措施才能有效地降低SSI的发生率。

不同洁净度手术间对颅脑外科手术部位感染的影响

目的研究两种不同洁净度的手术间对神经外科颅脑手术手术部位感染(SSI)的影响,为防控SSI提供参考。方法回顾性研究某院2015年7月—2016年7月神经外科在Ⅰ级和Ⅱ级手术间开展的颅脑手术病例,其中Ⅰ级手术间的病例为对照组,Ⅱ级手术间的病例为试验组,比较两组患者SSI发生情况。结果共调查颅脑手术患者454例,对照组(Ⅰ级手术间)212例,试验组(Ⅱ级手术间)242例。对照组患者发生SSI 25例,SSI发病率为11.79%;试验组患者发生SSI 31例,SSI发病率为12.81%。9例切口感染均为表浅切口感染,无深部切口感染,其余47例SSI均为颅内感染,即器官腔隙感染。两组患者SSI发病率比较,差异无统计学意义(P>0.05)。结论Ⅰ级和Ⅱ级两种不同洁净度的手术间对神经外科颅脑手术患者SSI无直接影响,应采取综合防控措施预防SSI的发生。

PDCA循环在规范Ⅰ类切口手术预防用抗菌药物中的应用

目的探讨某院应用PDCA循环管理在规范医院Ⅰ类切口手术围手术期合理预防使用抗菌药物的效果。方法选取2011年1—6月Ⅰ类切口手术患者,为实施PDCA循环前组;根据PDCA实施的3个循环过程,将2011年7月—2012年12月全院Ⅰ类切口手术患者分为3组。按照PDCA循环管理法的计划、实施、检查、处理程序,对Ⅰ类切口手术预防用抗菌药物进行管理和控制,对实施PDCA循环管理前后用药合理性进行对照研究。结果实施PDCA前,Ⅰ类切口手术预防使用抗菌药物率为100.00%(101/101),实施3个PDCA循环后,降至36.09%(61/169),差异有统计学意义(χ2=135.66,P<0.001);合理用药率由实施PDCA前的62.38%(63/101)提高至81.97%(50/61),差异有统计学意义(χ2=8.29,P=0.04)。实施PDCA前,51.49%(52/101)的患者术后用药时间>3 d;实施3个PDCA循环后,术后用药时间>3 d的患者降至7.69%,术后预防用药时间较前规范,无联合用药。结论实施PDCA循环管理在规范Ⅰ类切口手术预防用抗菌药物中成效显著。

胰腺外科手术部位感染率及危险因素分析

目的调查胰腺外科手术部位感染(SSI)率并探讨发生SSI的危险因素。方法回顾性分析196例胰腺外科手术患者的性别、年龄、术前住院时间、切口类型、美国麻醉协会(ASA)评分、手术时间。结果196例胰腺外科手术患者发生SSI14例,SSI发生率为7.1%。感染组与非感染组在性别、年龄、术前住院时间、切口类型、ASA评分差异均无显著性(P>0.05);感染组手术时间为(383.57±157.64)min,非感染组手术时间为(265.52±107.68)min,两者比较差异具有显著性(P<0.05)。结论引起胰腺外科手术SSI的主要原因为手术时间,而与术前住院时间、切口类型、ASA评分无相关性。

脊柱术后手术部位感染的危险因素分析

目的 :分析脊柱术后手术部位感染的危险因素,总结降低脊柱术后手术部位感染发生率的经验。方法 :收集我科自1995年1月~2015年12月实施脊柱开放手术患者的资料,对文献中常见脊柱术后感染高危因素高龄、糖尿病、肥胖、长手术时间、内固定置入、输血、长期吸烟史、类固醇激素服用史、全身其他部位感染、脑脊液漏、二次手术、后路手术等进行统计并行单因素卡方检验,筛选出阳性危险因素,对阳性危险因素进行多因素Logistic回归分析。结果:共有3964例患者实施脊柱开放手术,术后36例发生手术部位感染,其中男9例,女27例;年龄16~76岁(61.2±3.6岁)。其中合并糖尿病者12例,全身其他部位感染(包括慢性感染)3例,类固醇激素服用史(自身免疫性、代谢性疾病)1例。单因素卡方检验提示高龄、糖尿病、肥胖、长手术时间、内固定置入、输血是脊柱术后感染相关阳性危险因素。长期吸烟史、类固醇激素服用史、全身其他部分感染、脑脊液漏、二次手术、后路手术与脊柱术后感染无相关性。多因素Logistic回归分析提示:高龄、糖尿病、输血、内固定置入及长手术时间会增加脊柱术后手术部位感染的风险,其中长时间手术、肥胖、输血导致脊柱术后手术部位感染的风险最高,其次是糖尿病和内固定置入,而高龄在所有阳性危险因素中导致脊柱术后手术部位感染的风险最小。结论:肥胖、高龄、糖尿病、输血、内固定置入及长手术时间会增加脊柱术后手术部位感染的发生风险。对于有相关危险因素的患者,应尽早控制相关危险因素,加强围手术期预防以降低脊柱术后手术部位感染的风险。

剖宫产术后切口感染的术中和术后相关因素分析

目的探讨剖宫产切口感染术中、术后高危因素,为切口感染寻找最佳的预防措施和方法。方法采用回顾性调查方法,调查可能与切口感染相关的术中及术后高危因素,包括是否急诊、麻醉方式、手术时间、手术医师的操作、住院天数、术中和失血量、术后护理等7项指标,并根据随机原则,取同一医院未感染的产妇进行对照。结果在术中及术后的相关因素中,麻醉方式、住院天数、手术时间等3项指标在感染组和对照组有显著性差异(P<0.01)。失血量及急诊等2项指标经统计学分析,感染组和对照组无显著性差异(P>0.05)。结论针对影响剖宫产切口感染的术中和术后高危因素,应制定有效的预防措施,以减少术后感染的发生。