感染预防套餐修改对剖腹产后分娩手术部位感染的影响
Morgan Steelman1, Desmond Sutton1, Nathan S Fox1,2
1Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, United States.
American journal of perinatology
|January 30, 2026
概括
一个修改的手术部位感染 (SSI) 预防包,重点关注关闭阶段的设备变化,并没有降低剖腹产后的SSI率. 标准化核心SSI预防措施可能比仅仅额外的设备更改更具影响力.
科学领域:
- 产科和妇科 产科和妇科
- 预防传染病 预防传染病
- 外科手术的安全性
背景情况:
- 手术部位感染 (SSI) 是剖腹产后的一个重大问题.
- 现有的SSI预防包通常集中在术前和术后阶段.
- 特别针对SSI手术的关闭阶段的修改的影响不太清楚.
研究的目的:
- 评估改性手术部位感染 (SSI) 预防包在剖腹产后SSI率上的有效性.
- 修改具体涉及在剖腹产结束阶段使用的设备的更改.
- 为了确定是否增强的关闭阶段协议提供额外的好处超出标准的SSI预防.
主要方法:
- 一项回顾性队列研究分析了从2018年4月到2025年2月的2,467例剖腹产.
- 2021年9月实施的修订后的SSI预防包,包括在关闭期间改变手套,灯柄,Bovie和仪器使用.
- 后勤回归模型根据母亲和妊娠年龄进行调整;子组分析考虑了劳动状态,剖腹产前和BMI.
主要成果:
- 在实施前,SSI的发病率为2.6%,在实施后为3.3% (调整后OR为1.27,p=0.313).
- 在捆绑实施之前或之后,没有观察到SSI利率的显著时间趋势.
- 根据劳动状态,先前剖腹产和BMI的子组分析没有显示修改的捆绑和SSI风险之间的显著关联.
结论:
- 实施关闭阶段设备更改并没有显著降低剖腹产后的SSI率.
- 标准化的核心SSI预防措施 (抗生素,制剂,敷料) 可能是足够的,仅仅从设备更改中获得的额外好处有限.
- 在临床实践中广泛采用之前,对过程变化的严格评估至关重要.
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