Taylor E W, Duffy K, Lee K, Hill R, Noone A, Macintyre I, King P M, O'Dwyer P J
Department of Surgery, Inverclyde Royal Hospital, Greenock, UK.
Br J Surg. 2004 Jan;91(1):105-11. doi: 10.1002/bjs.4365.
Post-discharge surveillance for 30 days is needed to determine the true incidence of surgical site infection (SSI). This study was undertaken to determine the incidence of, and risk factors for, SSI after hernia repair.
A total of 3150 patients who had undergone groin hernia repair in 32 Scottish hospitals were telephoned 10, 20 and 30 days after operation to screen for SSI. Patients who believed the wound to be infected were seen by a healthcare worker to confirm the diagnosis. Details of operations and risk factors were obtained by case-note review.
One hundred and four patients (3.3 per cent) declined to give a contact telephone number, leaving 3046 patients who agreed to take part in the study. Some 108 patients (3.4 per cent) could not be contacted at any point, giving a response rate of 93.3 per cent. Complete data were available for 2665 patients (87.5 per cent); 140 (5.3 per cent) developed SSI and 57 (2.1 per cent) thought the wound infected but this was not confirmed by the healthcare worker. Patients given a prophylactic antibiotic had a lower incidence of SSI (P = 0.002), but neither increase in the American Society of Anesthesiologists grade of fitness for operation nor prolonged duration of operation was a significant risk factor for infection.
SSI after hernia repair is common and large clinical trials are required to determine whether the use of prophylactic antibiotics reduces the incidence of infection.
需要进行30天的出院后监测以确定手术部位感染（SSI）的真实发生率。本研究旨在确定疝修补术后SSI的发生率及危险因素。
对32家苏格兰医院的3150例行腹股沟疝修补术的患者在术后10天、20天和30天进行电话随访，以筛查SSI。认为伤口感染的患者由医护人员进行检查以确诊。通过查阅病历获取手术及危险因素的详细信息。
104例患者（3.3%）拒绝提供联系电话，剩余3046例患者同意参与研究。约108例患者（3.4%）在任何时间点均无法联系到，应答率为93.3%。2665例患者（87.5%）有完整数据；140例（5.3%）发生SSI，57例（2.1%）认为伤口感染但未得到医护人员确认。接受预防性抗生素治疗的患者SSI发生率较低（P = 0.002），但美国麻醉医师协会手术适宜性分级增加及手术时间延长均不是感染的显著危险因素。
疝修补术后SSI很常见，需要进行大规模临床试验以确定预防性使用抗生素是否能降低感染发生率。
