在小儿科狗咬伤伤害中,初级关闭后的术后伤口感染
Brielle Ochoa1, R Scott Eldredge1, Megan Gilbert1
1Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, Arizona.
The Journal of surgical research
|October 5, 2024
概括
将抗生素预防限制在儿科狗咬伤伤口修复后的3天内,可以安全地减少抗生素持续时间,而不会增加感染率. 这种标准化改善了儿科创伤护理.
科学领域:
- 儿童创伤外科手术
- 传染病管理 传染病管理
- 伤口护理协议 伤口护理协议
背景情况:
- 目前的指导方针建议在狗咬伤伤害时进行3-5天的抗生素预防.
- 临床实践各不相同,特别是在初级伤口关闭后.
- 实行了一项机构协议,将修复后的抗生素限制在最多3天内.
研究的目的:
- 分析一项新方案对儿科狗咬伤伤的抗生素持续时间的影响.
- 根据新协议,在初级关闭后确定伤口感染的发生率.
- 评估标准化,更短的抗生素持续时间的安全性和可行性.
主要方法:
- 儿童狗咬伤伤害 (≤18岁) 进行初级关闭 (2018-2022年) 的回顾性审查.
- 数据收集包括人口统计,临床细节和抗生素持续时间.
- 使用多变量回归分析来确定与伤口感染相关的因素.
主要成果:
- 实践后的平均抗生素持续时间从6.8日降至4.4天 (P<0.001).
- 较短的抗生素持续时间 (≤3天) 与伤口感染风险的增加无关.
- 术后伤口感染率在短期和长期抗生素组之间是相似的 (7.5%对7.1%,P = 0.912).
结论:
- 标准化术后抗生素持续时间为最多3天的儿科狗咬伤伤是可行的.
- 这种标准化有效地减少了对抗生素的暴露,而不会影响患者的安全或增加感染率.
- 这项研究支持多学科努力,以优化儿科创伤护理和抗生素管理.
相关概念视频
01:22Burn Injuries
Burn injuries occur when the skin and underlying tissues are damaged due to exposure to heat, electricity, chemicals, radiation, or friction. They can vary in severity, from minor superficial burns to severe deep burns that can be life-threatening.
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
01:28Rabies
Rabies is a lethal zoonotic disease caused by a single-stranded, negative-sense RNA virus of the Lyssavirus genus, within the family Rhabdoviridae. Its primary mode of transmission to humans is through bites or saliva-contaminated scratches from infected mammals such as dogs, bats, raccoons, or foxes. Transmission can also occur if infectious saliva contacts abraded skin or intact mucous membranes, including the conjunctiva.Viral Entry and Early ReplicationOnce introduced at the bite or scratch...
01:14Spinal Cord Injury ll: Pathophysiology
Spinal cord injury progresses through two interconnected phases: primary injury and secondary injury.Primary InjuryPrimary injury happens at the moment of trauma and involves immediate mechanical damage to the spinal cord.Compression happens when broken vertebrae, herniated discs, or accumulating blood (such as a hematoma) press directly against the spinal cord, distorting its normal shape and function. In cases of contusion, the cord is bruised by a blunt force (like penetrating injuries or...
01:25Secondary Spinal Cord Injury llI: Pathophysiology
Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...