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手術 部位 の 感染 の 予防: レビュー
Jessica L Seidelman1, Christopher R Mantyh2, Deverick J Anderson1
1Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, North Carolina.
JAMA
|January 17, 2023
まとめ
手術部位感染 (SSI) の予防は患者の回復に不可欠です. 正確な脱毛,皮膚の準備,ノルモテルミアの維持などの証拠に基づいた戦略を導入することで,SSIの割合を大幅に減らし,外科的結果を改善します.
科学分野:
- 感染対策
- 手術 の 結果
- 証拠 に 基づく 医学
背景:
- 手術部位感染 (SSI) は,手術を受けた患者の0. 5%から3%で,長期の入院 (7~11日以上) に繋がります.
- SSIは通常 手術中の手術部位の細菌汚染によるものです
- 感染の発生は,患者の免疫力,異物,細菌の量,抗生物質の予防によって影響を受けます.
研究 の 目的:
- 手術部位の感染を減らすための証拠に基づいた戦略をレビューし,強調する.
- 特定の介入がSSI率に与える影響を強調する.
- 患者の安全と結果を改善するために 臨床実務に情報を提供するためです
主な方法:
- ランダム化比較試験とSSI予防に関する国際ガイドラインのレビュー
- 特定の介入がSSI率に与える影響の分析
- 介入群と対照群の感染率の比較
主要な成果:
- 脱毛用の剃刀を避けたことにより,SSIは4.4%から2.5%に減少しました.
- 脱コロニゼーション,クロルヘキシジン/アルコールの皮膚調製,ノルモサーミア,血糖制御,および負圧傷療法は,SSIの有意な減少を示した.
- 適切な手術前抗菌予防が推奨されます.
結論:
- 具体的な証拠に基づいた戦略を導入することで 手術部位の感染率を大幅に減らすことができます.
- 重要な介入には,適切な脱毛,皮膚消毒,ノルモサーミア,血糖コントロール,NPWTが含まれます.
- 抗菌予防のガイドラインの遵守も推奨されます.
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