Background/Aims: Inguinal incisions are a common route of access in vascular surgery. Due to anatomical challenges and a diverse bacterial flora in this area, surgical site infections (SSI) represent a common, debilit...Background/Aims: Inguinal incisions are a common route of access in vascular surgery. Due to anatomical challenges and a diverse bacterial flora in this area, surgical site infections (SSI) represent a common, debilitating and sometimes life-threatening complication. The INVIPS-Trial evaluates the role of Negative Pressure Wound Therapy (NPWT) on closed inguinal incisions in elective vascular surgery to prevent SSI and other wound complications. Methods: This randomized controlled trial (RCT) registered at ClinicalTrials.gov (Identifier: NCT01913132) compares the effects of a NPWT dressing (PICO, Smith & Nephew, UK) and the center’s standard wound dressing (Vitri Pad, ViTri Medical, Sweden) on postoperative wound complications, especially SSI. The study includes two distinct vascular procedures with different SSI risk profiles: endovascular aortic repair (EVAR) and open surgical approaches involving the common femoral artery (OPEN). Results: Four hundred ninety-five groin incisions in both treatment arms are anticipated to be included in the EVAR group and 147 inguinal incisions in both treatment arms in the OPEN group. Since a large percentage of inguinal vascular procedures in both groups but especially in the EVAR group are performed bilaterally, many patients can serve as their own control by randomly receiving NPWT on one and the standard dressing on the contralateral inguinal incision. Conclusions: This ongoing RCT attempts to elucidate the potential benefit of NPWT on closed inguinal incisions after different vascular procedures. Outcome and conclusions of this trial could have implications on postoperative wound care of patients in both vascular surgery and other surgical specialties.展开更多
Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complic...Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.展开更多
目的：分析老年患者骨科植入物手术医院内获得性感染（ HAI ）的发生率及危险因素，探讨防控对策。方法回顾分析2013年7月1日至2015年6月30日期间在广州军区广州总医院行骨科植入物手术的老年患者1338例。统计分析HAI的发病情况及危险...目的：分析老年患者骨科植入物手术医院内获得性感染（ HAI ）的发生率及危险因素，探讨防控对策。方法回顾分析2013年7月1日至2015年6月30日期间在广州军区广州总医院行骨科植入物手术的老年患者1338例。统计分析HAI的发病情况及危险因素。结果发生HAI 103例，感染率7．7％。最常见的HAI部位为下呼吸道，占总感染的36．97％，其次为泌尿系统和手术深部切口，分别占35．29％和10．08％。共检出细菌数116株，多重耐药菌占63．79％，其中排在前5位细菌分别是大肠埃希菌、鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌和屎肠球菌。性别、年龄、手术类型、合并基础疾病、手术时间、术中输血量、术中输液量、住院时间和术前住院时间、侵入性操作和美国麻醉师协会（ ASA）评分与骨科植入物手术HAI发生率密切相关（P＜0．05）。结论为降低骨科老年患者植入物手术HAI的发生率，应注重老年患者骨科围手术期的各个环节：术前应做好充分评估，有效控制基础疾病；术中应尽量缩短手术时间，减少术中出血及输液量；术后需加强对呼吸机、中心静脉导管、导尿管等侵入性操作的流程管理。展开更多
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. P...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.展开更多
目的分析应用品管圈管理降低妇科术后医院感染发生率的效果。方法选取2015年1—6月我院收治的妇科手术患者278例,随机分为对照组(n=138)和观察组(n=140),对照组采用常规住院管理,观察组采用品管圈管理,将同期不同组别患者医院感染发生...目的分析应用品管圈管理降低妇科术后医院感染发生率的效果。方法选取2015年1—6月我院收治的妇科手术患者278例,随机分为对照组(n=138)和观察组(n=140),对照组采用常规住院管理,观察组采用品管圈管理,将同期不同组别患者医院感染发生率进行比较。结果观察组患者术后医院感染发生率低于对照组(P<0.05)。结论品管圈(quality control circle,QCC)活动的实施,提高了医护人员的观察和创新力,发挥参与管理的主动性和积极性,降低妇科术后医院感染发生率具有重要意义。展开更多
基金an unrestricted unconditional research grant 15,550 USD and donation of 100 PICO dressing kits from Smith and Nephew in 201312,900 USD from the Swedish SUS Stiftelser och Fonder:Grant-number 95407ClinicalTrials.gov(Identifier:NCT01913132).
文摘Background/Aims: Inguinal incisions are a common route of access in vascular surgery. Due to anatomical challenges and a diverse bacterial flora in this area, surgical site infections (SSI) represent a common, debilitating and sometimes life-threatening complication. The INVIPS-Trial evaluates the role of Negative Pressure Wound Therapy (NPWT) on closed inguinal incisions in elective vascular surgery to prevent SSI and other wound complications. Methods: This randomized controlled trial (RCT) registered at ClinicalTrials.gov (Identifier: NCT01913132) compares the effects of a NPWT dressing (PICO, Smith & Nephew, UK) and the center’s standard wound dressing (Vitri Pad, ViTri Medical, Sweden) on postoperative wound complications, especially SSI. The study includes two distinct vascular procedures with different SSI risk profiles: endovascular aortic repair (EVAR) and open surgical approaches involving the common femoral artery (OPEN). Results: Four hundred ninety-five groin incisions in both treatment arms are anticipated to be included in the EVAR group and 147 inguinal incisions in both treatment arms in the OPEN group. Since a large percentage of inguinal vascular procedures in both groups but especially in the EVAR group are performed bilaterally, many patients can serve as their own control by randomly receiving NPWT on one and the standard dressing on the contralateral inguinal incision. Conclusions: This ongoing RCT attempts to elucidate the potential benefit of NPWT on closed inguinal incisions after different vascular procedures. Outcome and conclusions of this trial could have implications on postoperative wound care of patients in both vascular surgery and other surgical specialties.
文摘Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.
文摘目的：分析老年患者骨科植入物手术医院内获得性感染（ HAI ）的发生率及危险因素，探讨防控对策。方法回顾分析2013年7月1日至2015年6月30日期间在广州军区广州总医院行骨科植入物手术的老年患者1338例。统计分析HAI的发病情况及危险因素。结果发生HAI 103例，感染率7．7％。最常见的HAI部位为下呼吸道，占总感染的36．97％，其次为泌尿系统和手术深部切口，分别占35．29％和10．08％。共检出细菌数116株，多重耐药菌占63．79％，其中排在前5位细菌分别是大肠埃希菌、鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌和屎肠球菌。性别、年龄、手术类型、合并基础疾病、手术时间、术中输血量、术中输液量、住院时间和术前住院时间、侵入性操作和美国麻醉师协会（ ASA）评分与骨科植入物手术HAI发生率密切相关（P＜0．05）。结论为降低骨科老年患者植入物手术HAI的发生率，应注重老年患者骨科围手术期的各个环节：术前应做好充分评估，有效控制基础疾病；术中应尽量缩短手术时间，减少术中出血及输液量；术后需加强对呼吸机、中心静脉导管、导尿管等侵入性操作的流程管理。
文摘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.
文摘目的分析应用品管圈管理降低妇科术后医院感染发生率的效果。方法选取2015年1—6月我院收治的妇科手术患者278例,随机分为对照组(n=138)和观察组(n=140),对照组采用常规住院管理,观察组采用品管圈管理,将同期不同组别患者医院感染发生率进行比较。结果观察组患者术后医院感染发生率低于对照组(P<0.05)。结论品管圈(quality control circle,QCC)活动的实施,提高了医护人员的观察和创新力,发挥参与管理的主动性和积极性,降低妇科术后医院感染发生率具有重要意义。
