骨科择期手术加速康复预防手术部位感染专家共识  

Expert consensus on enhanced recovery management for the prevention of surgical site infection after orthopaedic selective surgery

作　　者：国家卫生健康委加速康复外科专家委员会骨科专家组 中国研究型医院学会骨科加速康复专业委员会 中国康复技术转化及促进会骨科加速康复专业委员会 邱贵兴[2] 裴福兴[3] 黄强[3] 林吉[3] Orthopaedic Expert Group of ERAS profession Committee of National Health Commission;Orthopaedic ERAS profession Committee of Chinese Research Hospital Association;Orthopaedic ERAS profession Committee of China Association of Rehabilitation Technology Transformation and Promotion;QIU Guixing;PEI Fuxing

机构地区：[1]不详 [2]中国医学科学院,北京协和医学院,北京协和医院骨科 [3]四川大学华西医院骨科

出　　处：《中华骨与关节外科杂志》2022年第10期746-753,共8页Chinese Journal of Bone and Joint Surgery

摘　　要：手术部位感染是骨科择期手术后的严重并发症之一,常给患者带来灾难性的后果。为了规范骨科择期手术手术部位感染的预防措施,减少手术部位感染,提高医疗质量和安全,国家卫生健康委加速康复外科专家委员会骨科专家组、中国研究型医院学会骨科加速康复专业委员会、中国康复技术转化及促进会骨科加速康复专业委员会联合多学科专家成立骨科加速康复系列共识编写专家委员会,以临床问题为导向,遵循循证医学原则,归纳出3个方面的问题:(1)预防手术部位感染的术前管理措施(术前危险因素评估、潜在感染灶筛查、术前危险因素控制措施、术前皮肤准备);(2)预防手术部位感染的术中管理措施(手术室与人员管理、预防性应用抗菌药物、手术操作技术);(3)预防手术部位感染的术后管理措施(术后密切观察手术部位、纠正术后贫血和低蛋白血症、术后血糖监测、术后切口管理、术后合理使用预防性抗菌药物、出院后管理)。按照上述3个方面的问题进行文献检索和归纳,结合2020版《骨科择期手术加速康复预防手术部位感染指南》及近年国内外最新研究进展,从危险因素评估到术前、术中、术后的防控措施做了全面的总结和规范。经过反复讨论修改后形成本共识,期望其为我国骨科择期手术加速康复预防手术部位感染的多学科协作起到积极的推动作用,最终达到加速患者康复的目的。Surgical site infection is one of the serious complications after selective orthopaedic surgery,which often brings disastrous consequences to patients.In order to standardize the measures preventing surgical site infection,thus to reduce it,and improve the medical quality and safety,Orthopaedic Expert Group of ERAS profession Committee of National Health Commission,Orthopaedic ERAS profession Committee of Chinese Research Hospital Association,Orthopaedic ERAS profession Committee of China Association of Rehabilitation Technology Transformation and Promotion,together with experts from other relevant disciplines,established a collaborative expert committee for this consensus writing.Focusing on the clinical problems and following evidence-based medicine principles,the experts summarized the following three aspects:(1)preoperative preventive measures(preoperative risk factor assessment,screening of potential infection foci,preoperative risk factor control measures,preoperative skin preparation);(2)intraoperative management measures(management of operating room and personnel,application of prophylactic antibiotics,surgical techniques);(3)postoperative preventive measures(frequent observation for the operation site,correction of anemia and hypoproteinemia,postoperative blood glucose monitoring,postoperative incision management,rational use of prophylactic antibiotics,post-discharge management).Around these three aspects,literature was searched and induced,and the latest researches of recent years were referenced as well as the 2020 edition of Guideline on the prevention of surgical site infection for the enhanced recovery after surgery after elective orthopaedic surgeries.Through repeated discussions and revisions,this consensus was developed,which provided a comprehensive summary and standardization from risk factors assessment to preoperative,intraoperative and postoperative prevention and control measures,hoping to promote the multidisciplinary cooperation and realize rapid recovery for patients.

关 键 词：骨科择期手术 加速康复外科 手术部位感染 感染预防 

分 类 号：R68[医药卫生—骨科学]