切口保护套降低腹部手术患者切口感染的效果分析  

Analysis of incision protection device to reduce abdominal incision infections

作　　者：周学颖[1] 赵峰[1] 王萃[2] 杨春波[1] 周乐[3] 

机构地区：[1]吉林大学中日联谊医院手术室,吉林长春130033 [2]吉林大学中日联谊医院信息中心,吉林长春130033 [3]吉林大学中日联谊医院甲状腺外科,吉林长春130033

出　　处：《中华医院感染学杂志》2015年第19期4494-4496,共3页Chinese Journal of Nosocomiology

基　　金：吉林省科技厅基金资助项目(20130206062SF)

摘　　要：目的观察切口保护套在腹部手术患者术中对切口的保护作用,研究应用切口保护套对降低腹部手术切口感染的有效性,为预防腹部手术切口感染的发生提供科学依据。方法选取医院2014年2-7月进行的普通外科腹部择期手术300例,随机分为观察组和对照组,每组150例;观察组术中应用一次性切口保护套(牵开器)对切口进行保护,对照组术中常规应用无菌纱布垫对切口进行保护;术中对两组手术切缘进行细菌学监测,将切缘与感染切口病原菌进行菌种分析,并对两组患者发生术后切口感染率进行比较。结果切开腹膜时,观察组、对照组切缘细菌培养阳性率分别为1.3%和2.0%,两组比较差异无统计学意义;准备关腹前,观察组细菌检出阳性率为3.3%,明显低于对照组为25.3%,差异有统计学意义(P<0.01);观察组患者切口感染率2.0%,明显低于对照组的18.7%,差异有统计学意义(P<0.01);切缘及感染切口病原菌分析,其菌株构成前3位均为大肠埃希菌、肺炎克雷伯菌、凝固酶阴性葡萄球菌。结论切口感染与术中切缘受到污染有关,应用切口保护套可阻隔切缘与污染物接触,可有效降低术中切缘细菌阳性率,明显降低腹部手术患者术后切口感染发生率。OBJECTIVE To observe the protection effect of the protection device for abdominal incisions during sur‐gery and investigate the effectiveness of the protection device to reduce abdominal incision infections ,so as to pro‐vide scientific basis to prevent the happening of the abdominal incision infections .METHODS This study selected 300 cases of abdominal surgery conducted from Feb .2014 to Jul .2014 ,which were randomly divided into two groups ,namely the observation group and the control group ,with 150 cases in each group .The observation group used the disposable incision protection device （retractor） ,while the control group used the sterile gauze pad to protect the incision .Bacteriology monitoring on surgical cut edge was conducted for the two groups ,strain species from cut edges and incisions were analyzed ,and two groups of patients were compared for postoperative incision infection .RESULTS At the time of cutting the peritoneum ,the bacteria detection rate for cut edge was 1 .3% in the observation group and 2 .0% in the control group ,there was no difference between two groups .At the time of closing peritoneum ,the bacteria detection rate was 3 .3% in the observation group ,which was significantly lower than 25 .3% in the control group （P〈0 .01） .the rate of incision infection was 2 .0% in the observation group , significantly lower than 18 .7% in the control group （P〈0 .01） .The bacterial analysis of cut edges and incisions showed the top three bacteria were Escherichiacoli ,Klebsiellapneumoniae ,and coagulase‐negative Staphylococ‐cus aureus .CONCLUSION Incision infection is associated with intraoperative contamination of cutt edge ,applica‐tion of incision protection device can prevent the cut edge from contacting pollutants and can effectively reduce the bacterial positive rate for cut edge and significantly reduce the incidence of postoperative incision infections in pa‐tients undergoing abdominal surgery .

关 键 词：切口保护 切口感染 细菌学监测 

分 类 号：R619.3[医药卫生—外科学]