较少的损害控制拉巴切除术是否与手术部位感染的发生率和严重程度的降低有关?
Stephanie Martinez Ugarte1,2,3, Mokunfayo O Fajemisin1,2,3, Chelsea J Guy-Frank2,3
1Center for Translational Injury Research, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Surgical infections
|February 2, 2026
概括
尽管损伤控制腹腔切除术 (DCL) 率下降,外科手术部位感染 (SSI) 率和创伤腹腔切除术后的严重程度仍然稳定. 增加的伤害严重程度和透的创伤可能解释了这些发现,需要进一步研究可修改的风险因素.
科学领域:
- 创伤外科 手术 创伤外科
- 外科手术的结果
- 传染性疾病 传染性疾病
背景情况:
- 损伤控制腹腔切除术 (DCL) 的发生率有所下降.
- DCL与手术部位感染 (SSI) 的风险增加有关.
- 该研究调查了DCL率下降是否与SSI率和严重程度的下降相关.
研究的目的:
- 为了确定按Clavien-Dindo (CD) 分类分级的手术部位感染 (SSI) 率和严重程度是否与损伤控制腹腔切除 (DCL) 率的下降同时下降.
- 分析十年来SSI费率和严重性与DCL费率相关的趋势.
- 为了确定影响创伤腹腔切除术后SSI结果的因素.
主要方法:
- 从2011年至2020年,对1,975名创伤性腹腔切除术患者 (≥16岁) 进行了回顾性研究,不包括那些生存时间 ≤48小时的患者.
- 患者分为两个时期:2011-2015年 (DCL下降) 和2016-2020年 (持续低DCL).
- 手术部位感染 (SSI) 由CDC定义;严重程度按克拉维恩-丁多 (CD) 尺度分级 (小:I-II,大:III-V);进行统计分析.
主要成果:
- 伤害严重性评分 (ISS) 和穿透性伤害在两个时期之间增加.
- 损伤控制腹腔切除术 (DCL) 的发生率显著下降,从29%降至15%.
- 总体上,SSI率保持稳定 (18.5%对17.5%),在多变量分析中,DCL与主要的SSI相关.
结论:
- 创伤性腹腔切除术后手术部位感染 (SSI) 率和严重程度保持稳定,尽管损伤控制腹腔切除术 (DCL) 率下降.
- 伤害严重程度增加和透创伤的比例增加可能会导致SSI率稳定.
- 需要进一步的研究来确定可修改的风险因素,以减少SSI的发病率和严重程度.
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