Lynch W, Davey P G, Malek M, Byrne D J, Napier A
Pharmacoeconomics Research Centre, University of Dundee, Scotland, UK.
J Hosp Infect. 1992 Jul;21(3):179-91. doi: 10.1016/0195-6701(92)90074-v.
A total of 3482 general surgical patients entered a trial in which they had a chlorhexidine or placebo detergent shower three times before elective clean wound or potentially contaminated surgery. Patients who showered with a chlorhexidine detergent (N = 1744) had a significant reduction in skin flora compared with those who showered with a placebo detergent (N = 1738). The majority of wound infections occurred outside hospital (312 outpatient infections vs. 201 inpatient infections). Wound infection rates were similar in the chlorhexidine and placebo groups (5.79% vs. 5.75% for inpatient infections and 8.54% vs. 9.38% for outpatient infections). The average hospital cost of both non-infected and infected patients was higher in the chlorhexidine group. The average cost of a non-infected chlorhexidine patient was 847.95 pounds as opposed to 804.60 pounds for a non-infected placebo patient, whilst the average cost of an infected patient was 1459.70 pounds (chlorhexidine) and 1414.22 pounds (placebo). A cross-match comparison of patients undergoing vascular surgery revealed no statistical significance in the difference between the two experimental groups. Patients were matched for age, sex, type of operation and surgeon. We conclude that preoperative whole-body disinfection with a chlorhexidine detergent is not a cost-effective treatment for reducing wound infection.
共有3482名普通外科患者参与了一项试验，在择期清洁伤口手术或可能受污染的手术前，他们用洗必泰或安慰剂洗涤剂淋浴三次。与使用安慰剂洗涤剂淋浴的患者（N = 1738）相比，使用洗必泰洗涤剂淋浴的患者（N = 1744）皮肤菌群显著减少。大多数伤口感染发生在院外（门诊感染312例，住院感染201例）。洗必泰组和安慰剂组的伤口感染率相似（住院感染分别为5.79%和5.75%，门诊感染分别为8.54%和9.38%）。洗必泰组未感染和感染患者的平均住院费用均较高。未感染的洗必泰组患者平均费用为847.95英镑，而未感染的安慰剂组患者为804.60英镑，而感染患者的平均费用分别为1459.70英镑（洗必泰组）和1414.22英镑（安慰剂组）。对接受血管手术的患者进行交叉匹配比较发现，两个实验组之间的差异无统计学意义。患者在年龄、性别、手术类型和外科医生方面进行了匹配。我们得出结论，术前用洗必泰洗涤剂进行全身消毒对于减少伤口感染并非具有成本效益的治疗方法。
