Sellick J A, Stelmach M, Mylotte J M
Division of Infectious Diseases, State University of New York, Buffalo.
Infect Control Hosp Epidemiol. 1991 Oct;12(10):591-6. doi: 10.1086/646247.
To define accurate wound infection rates for the cardiac surgery service based on site of infection and characterization as "deep" or "incisional" and to determine whether a correctable cause for an apparent increase in deep wound infection rates existed.
Observational.
Tertiary-care teaching hospital.
All adults undergoing open heart surgery in 1988 and 1989.
Changed from razor to clipper preoperative hair removal in January 1989.
Deep sternotomy wound infections decreased significantly from 1.2% in 1988 to 0.2% in 1989 (p = .010) and deep venectomy (vein donor site) wound infections declined from 1.6% to 0.4% (p = .014) during the same time period. Incisional wound infection rates did not change. Patients with deep infections more likely required readmission or operation to treat their infection than those with incisional wound infections. The percentage of gram-negative organisms causing wound infections decreased from 56.3% in 1988 to 34.7% in 1989 (p = .017).
Preoperative hair removal using a clipper appears to have decreased the risk of deep wound infection compared with razor preparation. The dichotomous wound classification of "deep" and "incisional" distinguished between patients who required additional interventions for treatment of wound infections.
根据感染部位以及“深部”或“切口”的特征来确定心脏外科手术的准确伤口感染率，并确定深部伤口感染率明显增加是否存在可纠正的原因。
观察性研究。
三级护理教学医院。
1988年和1989年所有接受心脏直视手术的成年人。
1989年1月术前毛发去除从剃刀改为电动剃须刀。
在同一时期，深部胸骨切开伤口感染率从1988年的1.2%显著下降至1989年的0.2%（p = 0.010），深部静脉切除术（静脉供体部位）伤口感染率从1.6%降至0.4%（p = 0.014）。切口伤口感染率没有变化。与切口伤口感染患者相比，深部感染患者更有可能因感染需要再次入院或手术治疗。导致伤口感染的革兰氏阴性菌比例从1988年的56.3%降至1989年的34.7%（p = 0.017）。
与剃刀备皮相比，使用电动剃须刀进行术前毛发去除似乎降低了深部伤口感染的风险。“深部”和“切口”的二分法伤口分类区分了需要额外干预来治疗伤口感染的患者。
