在外科手术过程中的皮肤外伤.
J I Tokars1, D M Bell, D H Culver
1Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control, Atlanta, Ga 30333.
JAMA
|June 3, 1992
概括
外科人员经常经历穿皮损伤,主要是来自针,对自己和患者构成感染风险. 通过改进的外科设备和技术,可以预防许多伤害.
科学领域:
- 与医疗保健相关的感染
- 手术中的职业安全.
- 手术部位感染 手术部位感染
背景情况:
- 在手术期间的皮肤外伤会给医护人员和患者带来血液传播病原体传播的风险.
- 了解这些伤害的发生率和情况对于制定有效的预防策略至关重要.
研究的目的:
- 量化在手术环境中发生的皮肤外伤的频率和情况.
- 评估患者通过受污染的手术仪器接触卫生保健工作者血液的风险.
主要方法:
- 观察性研究设计涉及对美国四所教学医院的五个外科专业的1382次手术手术的直接监测.
- 通过现场观察员收集皮肤间伤害的数据,包括类型,机制和参与人员.
- 后勤回归分析以确定与受伤风险相关的因素.
主要成果:
- 6.9%的手术导致99种穿皮损伤,主要是来自针 (77%),影响非主导手.
- 在阴道切除术期间观察到较高的受伤风险,而在某些骨科手术中观察到较低的风险.
- 在 suturing 期间使用手指处理组织有助于 35% 的伤害; 32% 的外科医生伤害涉及重新接触患者的伤口.
结论:
- 在手术期间,皮肤上的伤害很常见,造成了重要的职业和患者安全风险.
- 专注于设备修改,技术改进和保护设备的预防措施至关重要,但需要严格评估疗效和对患者护理的影响.
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