扩张器或假体置入术后留置引流管感染危险因素分析

目的 探索乳房假体或者扩张器置入术后,留置引流管的时间、逆行冲洗与感染的关系.方法 对30例有>2处手术区域需要置入假体或者扩张器,术后留置引流管的患者进行研究,同一患者,两处引流管一侧术后早期进行逆行冲洗,一侧不进行逆行冲洗,在手术后的2、4、6、8 d以及拔管时在引流管出皮肤处皮肤、出皮肤处引流管和引流管末端分别取样,送细菌培养.结果 普通负压引流组和逆行冲洗的负压引流组送检菌培养标本各170例,阳性率分别是2.94%和1.76%,P=0.474;不同时间组,引流管不同部位的细菌检出率,在5～6 d组,引流管出皮肤处皮肤和出皮肤处引流管有细菌检出,约占9.09%,≥7 d,引流管末端的细菌检出率为33.33%;P<0.05.结论 引流管留置时间亦是导致引流管感染的重要因素,在严格的无菌操作下逆行冲洗不会增加感染.

Risk Factors for Infection on Drainage Set after Implants or Expander Transplantation

OBJECTIVE To study the risk factors related to the infection in the patients with the breast implant and soft tissue expander postoperatively, such as the time of drainage and retro-irrigation. METHODS Thirty consecutive patients who underwent breast implants and soft tissue expander involving at least two sites and set negative pressure drainage tube were studied. For each patient with drainages at two sites, one was retro-irrigated during the early stage postoperatively, the other was not. The samples were from the skin out of the drainage tube, the drainage tube out of skin and the end of drainage after 2, 4, 6 and 8 days of the operation and at the time of removing the tube. Total samples were tested for bacteriology. RESULTS Samples were divided into two groups: common groups and retro-irrigated group with negative pressure drainage. A total of samples from each group for bacterial test were 170. The postive rate was 2.94% and 1.76%, respectively (P=0.474). The positive rate of bacterial test was closely related to the time at all 3 different sampling sites (P<0.05). CONCLUSIONS The time of the drainage tube set is the important factor that leads to infection. With the strict asepsis procedure, retro-irrigation will not increase the infection rate.