在腹膜前骨盆包装后的开放固定与高的手术部位感染率有关
Ye Joon Kim1, Bryan L Scott1, Fredric M Pieracci2
1Departments of Orthopaedics, and.
Journal of orthopaedic trauma
|October 13, 2023
概括
腹前盆腔包装 (PPP) 增加了创伤患者手术部位感染 (SSI) 的风险. 将PPP与前置开放缩减和内部固定 (ORIF) 结合起来,进一步提高了这种风险,需要仔细考虑好处与危害.
科学领域:
- 创伤外科 手术 创伤外科
- 传染性疾病 传染性疾病
- 外科手术的结果
背景情况:
- 在骨盆骨折中持续的血液动力学不稳定性往往需要干预.
- 腹前骨盆包装 (PPP) 是一种用于管理严重的骨盆损伤的技术.
- 手术部位感染 (SSI) 是创伤护理中的一个重要并发症.
研究的目的:
- 为了确定骨盆空间手术部位感染 (SSI) 发生率,在腹前骨盆包装 (PPP) 后.
- 为了比较接受PPP的患者和没有PPP的开放降低和内部固定 (ORIF) 患者之间的SSI率.
- 在PPP之后识别与SSI相关的风险因素.
主要方法:
- 在城市1级创伤中心进行的回顾性比较研究.
- 包括接受PPP的83名患者和接受前骨盆环ORIF但没有PPP的55名患者.
- 倾向性得分匹配用于控制受伤严重程度得分和ASA得分的差异.
主要成果:
- 盆腔空间SSI的发生率在PPP组 (31.3%) 与对照组 (10.9%) 相比显著更高.
- 在倾向分数匹配的队列中,PPP组的SSI率仍然明显高 (30.2%) 与对照组 (9.3%) 相比.
- 多变量分析确定前部ORIF是接受PPP (OR = 6.56) 的患者SSI的独立风险因素.
结论:
- 腹前骨盆包装 (PPP) 是骨盆空间手术部位感染 (SSI) 的独立风险因素.
- 当与前部开放缩减和内部固定 (ORIF) 相结合时,PPP后SSI的风险进一步增加.
- 必须仔细权衡PPP在治疗脱血方面的潜在好处,并与SSI相关的增加发病率进行比较.
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