Watanabe Akihiro, Kohnoe Shunji, Shimabukuro Rinshun, Yamanaka Takeharu, Iso Yasunori, Baba Hideo, Higashi Hidefumi, Orita Hiroyuki, Emi Yasunori, Takahashi Ikuo, Korenaga Daisuke, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Surg Today. 2008;38(5):404-12. doi: 10.1007/s00595-007-3637-y. Epub 2008 Apr 30.
To assess the risk factors of surgical site infection (SSI) in gastrointestinal surgery.
Surgical site infection surveillance was conducted in 27 hospitals.
The incidence of SSI in the 941 patients studied was 15.5%. The factors associated with SSI were body mass index (BMI), comorbidity, emergency procedures, wound classification, blood loss, the suture material used for intra-abdominal ligation, the method of subcutaneous incision, the frequency of glove changes, and the absence of subcutaneous sutures. In lower alimentary tract procedures, additional factors influencing the incidence of SSI were sex, smoking status, operating time, the suture material used for abdominal wound closure and seromuscular sutures, and the combined resection procedures. According to a multiple logistic regression analysis, the independent risk factors for SSI were as follows: the type of operation, blood loss, wound classification, emergency procedures, the frequency of glove changes, the use of subcutaneous sutures, combined resection procedures, and the material used for seromuscular suturing.
Strict asepsis and minimal blood loss were associated with a lower incidence of SSI following gastrointestinal surgery. The use of absorbable suture material may be involved in reducing the risk of SSI.
评估胃肠外科手术部位感染（SSI）的危险因素。
在27家医院开展手术部位感染监测。
在研究的941例患者中，SSI发生率为15.5%。与SSI相关的因素有体重指数（BMI）、合并症、急诊手术、伤口分类、失血量、腹腔内结扎所用缝合材料、皮下切口方法、更换手套频率以及未使用皮下缝线。在下消化道手术中，影响SSI发生率的其他因素有性别、吸烟状况、手术时间、腹部伤口缝合和浆肌层缝合所用缝合材料以及联合切除手术。根据多因素逻辑回归分析，SSI的独立危险因素如下：手术类型、失血量、伤口分类、急诊手术、更换手套频率、使用皮下缝线、联合切除手术以及浆肌层缝合所用材料。
严格的无菌操作和最少的失血量与胃肠外科手术后较低的SSI发生率相关。使用可吸收缝合材料可能有助于降低SSI风险。
