Rogy M, Függer R, Riedl E, Schulz F
Chirurgische Universität, Allgemeines Krankenhaus, Wien.
Langenbecks Arch Chir. 1991;376(3):172-5. doi: 10.1007/BF00250343.
The incidence of postoperative wound infection ranges between 4.6% and 36% after gastrointestinal operations respectively. To evaluate the factors which influence the postoperative wound infection we prospectively analyzed our patients between 1/1989 and 1/1990. 444 patients from three general surgical units of our clinic entered this study. The overall wound infection rate was 6.3%. We classified the patients into 3 operative groups: Group I: subcutaneous operations; Group II: intraabdominal operations without opening the GI-tract; Group III: gastrointestinal operations. Wound infection rate in group I was 1.8%, in group II 7.3% and in group III 13.7%. The differences were highly significant. Both univariate (chi 2-test) as well as a multivariate (Cox-Model) analysis were done. We figured out that classification of patients (p = 0.000), operation time (p = 0.009), operating room (p = 0.000), intensive care unit (p = 0.026), long-term antibiotic prophylaxis (p = 0.001), subcutaneous haematoma (p = 0.000) and length of closed drainage time (p = 0.001) are of significant value. In the Cox model the classification of patients into 3 groups surpassed all the other factors. Postoperative hospital stay was lengthened in patients with wound infection significantly (p = 0.0025).
胃肠道手术后，伤口感染发生率分别在4.6%至36%之间。为评估影响术后伤口感染的因素，我们对1989年1月至1990年1月间的患者进行了前瞻性分析。我们诊所三个普通外科单元的444例患者纳入了本研究。总体伤口感染率为6.3%。我们将患者分为3个手术组：第一组：皮下手术；第二组：未打开胃肠道的腹腔内手术；第三组：胃肠道手术。第一组伤口感染率为1.8%，第二组为7.3%，第三组为13.7%。差异具有高度显著性。我们进行了单因素分析（卡方检验）和多因素分析（Cox模型）。我们发现患者分类（p = 0.000）、手术时间（p = 0.009）、手术室（p = 0.000）、重症监护病房（p = 0.026）、长期抗生素预防（p = 0.001）、皮下血肿（p = 0.000）和闭式引流时间（p = 0.001）具有显著意义。在Cox模型中，将患者分为3组这一因素超过了所有其他因素。伤口感染患者的术后住院时间显著延长（p = 0.0025）。
