实地无菌的应用,以安全地降低裂口手术的成本和浪费
Peter J Taub1, Olachi Oleru, Max G Mandelbaum
1Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
The Journal of craniofacial surgery
|August 17, 2023
概括
在手术中实地无菌可以降低成本和浪费,而不会增加感染风险. 对于裂口手术,由于感染率较低,标准无菌协议可能是不必要的,可以节省大量资金.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 外科手术的安全性
- 减少医疗废物 减少医疗废物
背景情况:
- 美国的医疗保健支出需要进行成本控制改革.
- 医疗用品是医院的一大支出.
- 实地无菌是一种减少资源过度使用和医疗废物的策略,而不会影响安全.
研究的目的:
- 评估不同外科手术过程中现场无菌的成本效益和安全性.
- 确定所有手术干预,特别是裂口手术是否需要标准无菌协议.
主要方法:
- 一个关于PubMed,Medline和Cochrane数据库 (1980-2022) 的综合文献综述.
- 包括不同手术环境中的实地无菌性,手套使用和手术部位感染的研究.
- 关键词集中在不育,成本和特定的程序,如裂手术和手术.
主要成果:
- 从827个初始结果中,包括了23篇文章.
- 在手术部位感染 (SSI) 率上没有显著差异,当比较外科医院和手术手术主要手术室的野外无菌性时.
- 实质性的成本节约和医疗废物减少,观察到田间无菌性.
- 伤口关闭,病变切除或使用非无菌手套进行莫斯手术的SSI没有差异.
结论:
- 与裂相关的手术中感染的发病率较低表明,野外无菌是一种可行的选择.
- 对于许多裂口程序,标准操作协议和相关的成本/浪费可能是不合理的.
- 现场无菌性在特定的手术环境中为成本效益和减少浪费提供了一个有希望的方法.
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