To establish whether the rates of surgical site infection (SSI) in gastrointestinal surgery are affected by the type of intra-abdominal suturing: sutureless, absorbable material (polyglactin: Vicryl), and silk.
Methods
We conducted SSI surveillance prospectively at 25 hospitals.
Results
The overall SSI rate was 14.4% (130/903). The SSI rates in the sutureless, Vicryl, and silk groups were 4.8, 14.8, and 16.4%, respectively, without significant differences among the groups. In colorectal surgery, the SSI rate in the Vicryl group was 13.9%, which was significantly lower than that of the silk group (22.4%; P?=?0.034). The incidence of deeper SSIs in the Vicryl group, including deep incisional and organ/space SSIs, was significantly lower than that in the silk group (P?=?0.04). The SSI rates did not differ among the suture types overall, in gastric surgery, or in appendectomy.
Conclusion
Using intra-abdominal absorbable sutures instead of silk sutures may reduce the risk of SSI, but only in colorectal surgery. 相似文献
This study aimed to identify and compare risk factors for surgical site infection (SSI) and non-surgical site infections (non-SSIs), particularly urinary tract infection (UTI), after spine surgery.
Methods
We retrospectively reviewed 825 patients (median age 59.0 years (range 33–70 years); 442 males) who underwent spine surgery at Kagoshima University Hospital from January 2009 to December 2014. Patient parameters were compared using the Mann–Whitney U and Fisher’s exact tests. Risk factors associated with SSI and UTI were analyzed via the multiple logistic regression analysis. P < 0.05 was considered statistically significant.
Results
SSI occurred in 14 of 825 cases (1.7 %), and non-SSI occurred in 23 of 825 cases (2.8 %). Most non-SSIs were UTIs (20 of 23 cases, 87.0 %). In the 14 patients with SSI, UTI occurred before SSI onset in one patient, and after SSI onset in two patients. UTI onset before SSI was not a risk factor for SSI. Multiple logistic regression analysis indicated that common risk factors for SSI and UTI were operation time (P = 0.0019 and 0.0162, respectively) and ASA classification 3 (P = 0.0132 and 0.0356, respectively). The 1 week post-operative C-reactive protein (CRP) level was a risk factor for UTI (P = 0.0299), but not for SSI (P = 0.4996).
Conclusions
There was no relationship between SSI and symptomatic UTI after spine surgery. Risk factors for post-operative SSI and UTI were operative time and ASA classification 3; 1 week post-operative CRP was a risk factor for UTI only.
<正>手术部位感染(surgical site infection,SSI)是指术后发生在切口、手术深部器官或腔隙的感染[1、2]。SSI根据发生的部位可分为浅部感染(位于皮肤及皮下组织)、深部感染(位于深筋膜和肌肉)和相邻组织器官间隙感染[3],其中美国疾病控制预防中心制定的切口深部感染诊断标准为感染发生在术后1个月(无植入物)或1年内(有植入物),感染与外科手术有关,以及感染累及切口深部组织(如肌肉和筋膜),并符合下列条件之一:来自切口深部组织的脓性分泌物;切口自然裂开或因故由外科医师打开;经直接检查、手术探查或组织病理、放射检查等发现切口深部脓肿或其他感染证据;外科医生或会诊的内科医生诊断的切口深部感染[2]。 相似文献
Methicillin-sensitive Staphylococcus aureus (MSSA) carriage may confer a significant risk of surgical site infection (SSI) and is common amongst the UK population. Screening for MSSA is not routinely offered to patients in the UK. Primary aim was to review the impact of introducing a MSSA screening programme, in addition to established Methicillin-resistant Staphylococcus aureus (MRSA) screening, on the incidence of SSIs following lumbar spine surgery.
Methods
A consecutive group of 1307 patients during 12 months before (phase 1: n?=?716) and after (phase 2: n?=?591) introduction of the MSSA screening programme were compared. Analysis was restricted to those with inpatient stay greater than 4 days, readmission within 6 weeks and a rising CRP 7 or more days following the procedure. Diagnosis of SSI was based around the CDC guidelines for wound surveillance. Patients were excluded where the primary surgery was to treat infection, or the procedure was percutaneous. Chi-squared test was used to compare the two groups.
Results
Seven hundred and sixteen patients were in phase 1. Rate of infection was 2.65%. Rate of MRSA colonisation was 0%. Five hundred and ninety-one patients were in phase 2. Rate of infection was 1.02%. Rate of MRSA colonisation was 0%, and rate of MSSA colonisation was 26%. Reduction in incidence of SSIs was 62% (p?=?0.0409).
Conclusion
MSSA colonisation is common, although wound infection following lumbar spinal surgery remains a rare event. A screening programme for MSSA can significantly reduce incidence of SSIs in this patient group. These findings may be applicable to wider elective orthopaedic practice.
Graphical abstract
These slides can be retrieved under Electronic Supplementary Material.
Surgical site infection is a common complication of surgery. Its morbidities range from delayed healing to systemic sepsis. It has impact on the economy and health care resources.
Methods
This study was a prospective, randomized, double-blinded, controlled multicenter study aimed to compare triclosan-coated polyglactin 910 sutures with polyglactin 910 sutures for the reduction of surgical site infections. This article details the results from the Cairo University center. A total of 450 patients who had undergone different surgical procedures were enrolled; 230 were enrolled in the study group and 220 were enrolled in the control group.
Results
The study group and the control group were comparable regarding risk factors for surgical site infection. Surgical site infection incidence was 7% in the study group and 15% in the control group (P = .011). The mean extended stay as a result of infection was 3.71 days, with an average cost $91 US per day.
Conclusions
Use of the triclosan-coated polyglactin 910 antimicrobial suture lead to reduction of surgical site infection and has an impact on saving health care resources. The triclosan-coated polyglactin 910 antimicrobial suture could save $1,517,727 yearly in this single center. 相似文献
