两个捆绑的比较,以减少手术部位感染在结直肠外科手术:多中心队列研究
Miriam Flores-Yelamos1,2, Aina Gomila-Grange3, Josep M Badia1,2
1Department of Surgery, Hospital General de Granollers, Granollers, Spain.
BJS open
|August 6, 2024
概括
实施顺序性手术部位感染预防捆绑可在结直肠手术中显著减少50%的感染. 增强的包装改善了合规性,降低了患者住院和死亡率.
科学领域:
- 感染控制 感染控制
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 关于手术部位感染 (SSI) 预防包的最佳元素数量存在争议.
- 在多中心环境中实施全面的SSI预防包的可行性仍然不清楚.
研究的目的:
- 在选择性结直肠外科手术中分析SSI率,在两个预防性捆绑协议的顺序实施后.
- 评估各个SSI预防措施的遵守及其有效性.
- 评估对患者住院时间,微生物学和30天死亡率的影响.
主要方法:
- 一项务实,多中心的队列研究,涉及32,205名接受选择性结直肠手术的患者.
- 顺序实施两个不同的SSI预防捆绑 (捆绑-1和捆绑-2).
- 分析SSI率,遵守,逗留时间,微生物学和死亡率.
主要成果:
- 总体SSI率下降了50%,从18.16% (基线) 降至10.03% (捆绑-1) 和8.19% (捆绑-2).
- 捆绑-2显著减少了表面和深层SSI,但没有器官/空间SSI.
- 随着时间的推移,遵守"捆绑-2"的情况有所增加,住院时间和死亡率显著下降.
结论:
- 通过增加SSI预防措施的数量,可以获得累积的保护作用.
- 器官/空间SSI没有显示增加措施的显著益处,并且没有确定直肠手术的保护因素.
- 综合包的顺序实施是可行的,并改善合规性,减少SSI,停留时间和死亡率.
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