牛皮是初级TKA后手术部位感染的危险因素
Caleb Durst1,2, Lily Rajaee1,3, Kenny Chang1,4
1Department of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Clinical orthopaedics and related research
|February 20, 2024
概括
患有牛皮的患者在全膝关节置换 (TKA) 后,表面手术部位感染 (SSI) 的风险更高. 这项研究强调了牛皮是TKA后表面SSI的重要危险因素.
科学领域:
- 整形外科手术 整形外科手术
- 皮肤病学 皮肤病学
- 流行病学 流行病学
背景情况:
- 牛皮和全膝关节整形术 (TKA) 后的并发症之间的联系需要进一步澄清.
- 关于牛皮和TKA并发症的现有研究是有限的,关于手术部位感染 (SSI) 风险的相互矛盾的发现.
研究的目的:
- 为了确定牛皮患者在初级全膝关节整形术 (TKA) 后是否有表面和深部手术部位感染 (SSI) 的风险增加.
- 为了比较患有牛皮和没有牛皮的患者之间的SSI率,控制混因素.
主要方法:
- 使用PearlDiver数据库 (n=248,492) 进行的一项大型队列研究,将牛皮患者 (n=1078) 与对照患者进行比较.
- 分析包括18岁以上的患者,在2015-2019年间接受了初级TKA,但不包括特定类型的关节炎患者和<2年随访的患者.
- 多变量分析评估了表面和深层SSI,无菌修订和麻醉下的操纵率.
主要成果:
- 患有牛皮的患者在初级TKA后显示总体SSI (OR 1.74) 和表面SSI (OR 2.83) 的几率显著更高.
- 在牛皮患者和对照人群之间没有观察到深层SSI率的显著差异 (OR 1.32).
- 牛皮与无菌修复或在麻醉下操纵的几率增加无关.
结论:
- 牛皮被确定为一次性TKA后表面SSI的危险因素.
- 外科医生在评估TKA患者时应将牛皮视为显著的并发症.
- 建议进行进一步的研究,以探索在患有牛皮的患者中减少表面SSI风险的干预措施.
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