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在手术期间浸泡消毒剂溶液是否会减少脊柱手术中的微生物污染? 一个随机对照试验

Yuan-Fu Liu¹, Yu-Chia Hsu², Po-Lin Chen³

¹Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

The spine journal : official journal of the North American Spine Society

|May 7, 2025

概括

与正常盐水和povidone-iodine相比,基酸 (CHG) 在腰部融合手术期间显著降低了植入物表面的细菌污染. 这项研究强调了CHG作为脊柱手术的有希望的消毒剂,以对抗手术部位感染.

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
抗菌剂抗菌剂抗菌剂

背景情况:

手术部位感染 (SSI) 是仪器脊柱手术的一个重要并发症,增加了患者的发病率和医疗费用.
标准的手术前消毒方案不能完全消除细菌污染,需要进一步的预防策略.
不同的手术内消毒剂解决方案在脊柱手术中减少污染的比较有效性尚未得到充分证实.

研究的目的:

评估使用常规盐水 (NS),波维- (PVP-I) 和素酸盐 (CHG) 浸泡手术内消毒剂溶液在减少细菌污染方面的有效性.
在腰部仪器融合手术期间评估表面组织,深层组织和植入物表面的细菌减少.
在不同消毒剂组中比较术后SSI和临床并发症的发生率.

主要方法:

一个单中心,单盲,随机对照试验,涉及105名患者接受后腰椎体融合.
患者被随机分为三个组:正常盐水 (NS),波维- (PVP-I) 或素酸盐 (CHG),每组接受3分钟的浸泡.
从三个地点采集了手术内抽样,用于细菌培养和16S rRNA PCR分析.

主要成果:

正常的盐水显示没有显著的细菌减少. 波维-证明了表面污染的减少,但在更深层的组织或植入物中没有.
赫西丁葡萄酸盐 (CHG) 显示出最大的细菌减少,在植入物表面显著超过NS和PVP-I.
尽管细菌减少有显著差异,但术后SSI的发生率在所有组中都是低的和可比的,没有与消毒剂相关的并发症.

结论:

在腰部融合手术中,即使经过标准消毒,细菌污染仍然存在;手术期间的消毒灌可以进一步降低这种负担.
在减少细菌污染方面,素酸盐 (CHG) 优于普通盐水和波维-,特别是在植入物表面.
作为脊柱外科手术的手术内消毒剂,CHG显示出有前景,因此需要进一步的多中心研究来证实其对减少SSI和长期结果的影响.

关键词:

消毒灌消毒灌消毒灌赫西丁糖酸盐 (CHG) 是一种植入物感染植入物感染脊柱外科手术脊柱外科手术手术部位感染 (SSI) 是一种手术部位感染.

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