创伤伤口患者居家洗浴与伤口感染现况调查及伤口感染影响因素分析:一项多中心研究  

Inventory Survey of Home Bathing and Wound Infection in Patients with Traumatic Wounds and Analysis of the Influencing Factors of Wound Infection:a Multicenter Study

作　　者：蒋琪霞 徐娟 王亚玲 解怡洁 郑美春[5] 王蔚蔚 孙红玲[7] 冯欢 嵇会明 白育瑄 JIANG Qixia;XU Juan;WANG Yaling;XIE Yijie;ZHENG Meichun;WANG Weiwei;SUN Hongling;FENG Huan;JI Huiming;BAI Yuxuan(Department of Burn and Plastic Surgery,General Hospital of Eastern Theater Command,Nanjing 210002,China;Department of Orthopaedics,Suqian Hospital of Nanjing Drum Tower Hospital Group,Suqian 223800,China;Nursing Department,Army Medical Center of PLA,Chongqing 400042,China;Department of Outpatient,Affiliated Hospital of Jiangnan University,Wuxi 214035,China;Department of Colorectal Surgery,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Department of Joint Orthopedics,the Second Navy Hospital of Southern theater Command,Sanya 572000,China;Department of Outpatient,tthe Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Urology Surgery,Xinqiao Hospital ARMY Medical University,Chongqing 400037,China;Department of Outpatient,the 904 hospital of Joint Logistics Support Force,Wuxi 214008,China;Clinical Academic Department,Zhejiang Top-Medical Dressing Co.,Ltd.,Wenzhou 325000,China)

机构地区：[1]东部战区总医院烧伤整形科,江苏省南京市210002 [2]南京市鼓楼医院集团宿迁医院骨科,江苏省宿迁市223800 [3]陆军特色医疗中心护理部,重庆市400042 [4]江南大学附属医院门诊部,江苏省无锡市214035 [5]中山大学附属肿瘤医院结直肠外科,广东省广州市510060 [6]南部战区海军第二医院关节骨科,海南省三亚市572000 [7]浙江大学医学院附属第二医院门诊部,浙江省杭州市310009 [8]陆军军医大学附属新桥医院泌尿外科,重庆市400037 [9]联勤保障部队第904医院门诊部,江苏省无锡市214008 [10]浙江医鼎医用敷料有限公司临床学术部,浙江省温州市325000

出　　处：《中国全科医学》2021年第29期3757-3762,共6页Chinese General Practice

基　　金：全军卫勤创新能力专项课题(20WQ027);上海王正国创伤医学发展基金会课题(WZGF20200101)。

摘　　要：背景创伤后洗浴是保持皮肤清洁的重要手段,但如何洗浴一直存有争议,有研究报道术后温水淋浴不增加伤口感染率,居家洗浴是否可行尚缺乏证据支持。目的多中心调查创伤伤口患者居家洗浴及伤口感染的现况,分析居家洗浴与伤口感染的相关性以及伤口感染的影响因素,为选择适宜的洗浴方法提供依据。方法2020年9月纳入13所医院伤口护理门诊创伤伤口患者为研究对象,设计创伤伤口患者居家洗浴与伤口感染现况的调查问卷,包括人口学资料、创伤伤口资料、创伤后洗浴及伤口感染资料等。通过问卷星链接或二维码自愿完成在线问卷的匿名填写及提交。分别采用描述性分析和多因素Logistic回归分析居家洗浴和伤口感染的现况及其影响因素。结果共收到949份问卷,剔除2份无效问卷,有效问卷947份,有效率为99.8%。(1)基本资料:男460例,女487例;年龄18~100岁,平均年龄(50.2±17.9)岁。创伤持续时间(42.7±66.7)d,全皮层损伤和部分皮层损伤分别占55.8%(528/947)和44.2%(419/947);致伤原因中以利器切割伤和跌倒外伤为主,分别占43.4%(411/947)和27.8%(263/947)。(2)伤后居家洗浴现况:伤后从未洗浴者占28.0%(265/947),带伤居家洗浴者占72.0%(682/947);洗浴方式以温水擦浴为主,占76.7%(523/682),包裹和敞开伤口温水淋浴分别占18.3%(125/682)和5.0%(34/682);洗浴以1次/周最多,占38.4%(262/682),其次为2次/周37.4%(255/682)和3次/周24.2%(165/682)。(3)伤口感染现况:伤口总感染率为36.0%(341/947),带伤居家洗浴者伤口感染率为24.6%(168/682),伤后从未洗浴者伤口感染率为65.3%(173/265),差异有统计学意义(χ^(2)=136.900,P<0.001);其中温水擦浴、包裹和开放伤口温水淋浴者伤口感染率分别为25.8%(135/523)、20.0%(25/125)和23.5%(8/34),差异无统计学意义(χ^(2)=1.860,P=0.395);居家洗浴频次1次/周者、2次/周者和3次/周者伤口感染率分别为32.8%(86/262)、22.4%(57/Background Posttraumatic bathing is an important means to keep skin clean,but how to bathe has always been controversial.Studies have reported that warm water shower after operation does not increase the wound infection rate,and there is still a lack of evidence to support the feasibility of bathing at home.Objective To investigate the current situation of home bathing and wound infection in patients with traumatic wounds by a multicenter investigation,and analyze the correlation between bathing and wound infection,and the influencing factors of wound infection,so as to provide the basis for the selection of appropriate bathing methods.Methods From September 1 to September 30 in 2020,wound patients in wound care clinics of 13 hospitals were selected as the research objects.A questionnaire was designed to investigate the current situation of home bathing and wound infection in patients with traumatic wounds,including demographic data,wounds data,post-traumatic bathing and wound infection data.Anonymous filling and submission of online questionnaire were completed voluntarily through star link,QR code.Descriptive analysis and multivariate Logistic regression analysis were used to analyze the current situation and related factors of home bathing and wound infection.Results A total of 949 questionnaires were received,excluding 2 invalid questionnaires,including 947 valid questionnaires,and the effective rate was 99.8%.(1)Basic data:460 males and 487 females,aging from 18 to 100 years old,the average age was(50.2±17.9)years.The duration of trauma was(42.7±66.7)d.Full thickness injury and partial thickness injury accounted for 55.8%(528/947)and 44.2%(419/947),respectively.The main causes of injury were sharp cutting injury and falling injury accounted for 43.4%(411/947)and 27.8%(263/947).(2)The status of home bathing after injury:28.0%(265/947)who never bathed at home after injury,72.0%(682/947)who bathed at home with injury.The main bathing method was warm water wiping bath for 76.7%(523/682),warm water shower by wr

关 键 词：伤口感染 创伤和损伤 皮肤清洗 洗浴 横断面研究 多中心研究 

分 类 号：R63[医药卫生—外科学]