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开口骨折后的多微生物感染的季节性变化和手术前风险因素
Madeline S Tiee1, Madeline M Lyons1, Philip G Ghobrial2,3
1Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL, USA.
Journal of clinical orthopaedics and trauma
|August 28, 2024
概括
骨折相关感染 (FRIs) 在开放骨折后很常见. 风险因素包括医院间转移和温暖的天气,这表明调整的抗生素预防可能会降低感染率.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 创伤护理 创伤护理
背景情况:
- 骨折相关感染 (FRI) 率仍然很高,尽管在开放骨折管理方面取得了进展.
- 观察到FRI致病生物的季节性和区域性变异.
- 了解致病生物和手术前风险因素对于管理FRIs至关重要.
研究的目的:
- 在一级创伤中心调查FRI的致病生物.
- 确定与FRI发展相关的术前风险因素.
- 分析FRI病原体和患者结局的季节性变化.
主要方法:
- 从2007年至2019年,对695名患有开放骨折的患者进行了回顾性队列研究,这些患者接受了灌和除菌.
- 排除有枪伤,手伤和不到3个月的随访时间的患者.
- 基于季节,伤害特征,人口统计,初始治疗和致病生物体的FRI患者的比较.
主要成果:
- 11.2%的患者患有FRI,其中格拉姆阳性生物体最常见 (81.1%).
- 在夏季和秋季观察到更高的FRI率 (p < 0.01).
- 医院间转移 (63.6%对41.2%,p=0.03) 和温暖/潮湿的天气与多微生物感染有关.
结论:
- 医院间转移和温暖/潮湿的天气是多微生物FRIs的手术前风险因素.
- 在温暖的月份或转移患者扩大抗生素预防可能会降低感染率.
- 有针对性的抗生素策略可以改善开口骨折患者的治疗结果.
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