挑战范式:在骨折后下感染的发生率
Louisa B Ragsdale1, Caroline C Kreh, Andi Zhang
1Division of Plastic and Reconstructive Surgery, Saint Louis University School of Medicine, Saint Louis, MO.
The Journal of craniofacial surgery
|February 13, 2025
概括
下骨折的亚急性管理是安全的,与早期固定相比,没有增加感染风险. 像吸烟和使用克林达米这样的因素,而不是手术时间,可以预测感染.
科学领域:
- 口腔和牙面部外科手术
- 创伤外科 手术 创伤外科
- 传染性疾病 传染性疾病
背景情况:
- 下骨折固定的最佳时间仍在争论中.
- 人们对口腔植物附近存在的感染风险存在担忧.
- 早期固定通常是为了减轻潜在的并发症而提倡的.
研究的目的:
- 评估在亚急性时期治疗下骨折的安全性和感染率.
- 为了确定下骨折患者感染的预测因素.
- 挑战早期手术干预对于预防感染至关重要这一假设.
主要方法:
- 从2013年到2023年,对640名下骨折患者进行了回顾性分析.
- 对患者,伤害,医疗和手术细节的审查,包括区域剥夺指数 (ADI).
- 使用千平方,单变量和后勤回归的统计分析来识别感染预测因素.
主要成果:
- 总体感染率为3.8%,通常在手术后的第三个月出现.
- 伤害机制,吸烟史和口服克林达米是感染的重要预测因素 (P <0.005).
- 手术的时间,抗生素的时间,抗生素的持续时间,骨折位置和ADI并没有影响感染率.
结论:
- 下骨折的亚急性治疗不会增加感染风险.
- 外科医生无法控制的因素,如并发症和受伤机制,可能是感染风险因素.
- 应将重点从手术时间转移到预防感染的患者特异性风险因素.
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