Huckfeldt Roger, Redmond Clyde, Mikkelson Debbie, Finley Phillip J, Lowe Cindy, Robertson Jennifer
St. John's Regional Health Center, Springfield, MO 65804, USA.
Ostomy Wound Manage. 2008 Oct;54(10):36-41.
Mediastinitis is a rare but serious postoperative complication of cardiac surgery that increases mortality rates, hospital length of stay, and medical costs. A clinical trial was conducted to investigate whether the type of postoperative surgical dressing (silver nylon or standard gauze) affects the rate of mediastinal infections. The sample consisted of 1,600 surgical cardiac patients. Infection rates in the standard gauze group (control, n = 1,235) were collected retrospectively from 24 months of infection control records. In the prospective treatment arm of the study, the wounds of all consecutive surgical patients (n = 365) were covered with a silver nylon dressing and patients were assessed during the 3-week postoperative visit. Thirteen (13) patients in the control group (1%) and none of the patients in the treatment group developed mediastinitis (chi2 [1, N = 1,600] = 3.88, P <0.05). Study findings support the need for a large, prospective, controlled clinical study to confirm the effects of these dressings on mediastinitis, resultant morbidity, and costs of care.
纵隔炎是心脏手术一种罕见但严重的术后并发症，会增加死亡率、住院时间和医疗费用。开展了一项临床试验，以调查术后手术敷料类型（银尼龙或标准纱布）是否会影响纵隔感染率。样本包括1600名心脏手术患者。标准纱布组（对照组，n = 1235）的感染率是从24个月的感染控制记录中回顾性收集的。在该研究的前瞻性治疗组中，所有连续手术患者（n = 365）的伤口均用银尼龙敷料覆盖，并在术后3周随访期间对患者进行评估。对照组中有13名患者（1%）发生纵隔炎，治疗组中无患者发生纵隔炎（卡方检验[1，N = 1600] = 3.88，P <0.05）。研究结果支持开展一项大型、前瞻性、对照临床研究，以确认这些敷料对纵隔炎、由此导致的发病率和护理费用的影响。
