Taylor G J, Bannister G C, Calder S
Winford Orthopaedic Hospital, Bristol, Avon.
J Hosp Infect. 1990 Oct;16(3):241-7. doi: 10.1016/0195-6701(90)90112-2.
Between 1981 and 1987, 12,907 [corrected] consecutive open elective orthopaedic procedures were performed. The in-patient infection rate was 1.43%. There was a significantly greater risk of infection in revision total knee replacement (15.3%), ankle fusion (9.3%), subtalar fusion (5.8%), primary total knee replacement (5.7%), spinal fusion (5.7%) and revision total hip replacement (4.5%). Revision surgery carried approximately a threefold greater risk than primary procedures. Staphylococci were present in 83% of positive wound cultures. Infection rates varied among surgeons but when number and type of procedure were taken into account only two surgeons differed significantly from that expected. Patients undergoing spinal and hindfoot fusion suffered considerable morbidity as a consequence of wound infection. Antibiotic prophylaxis may be helpful in these procedures.
1981年至1987年间，共连续进行了12907例（校正后）择期骨科开放性手术。住院感染率为1.43%。翻修全膝关节置换术（15.3%）、踝关节融合术（9.3%）、距下关节融合术（5.8%）、初次全膝关节置换术（5.7%）、脊柱融合术（5.7%）和翻修全髋关节置换术（4.5%）的感染风险显著更高。翻修手术的感染风险约为初次手术的三倍。83%的阳性伤口培养物中存在葡萄球菌。不同外科医生的感染率有所差异，但在考虑手术数量和类型后，只有两名外科医生的感染率与预期有显著差异。接受脊柱和后足融合术的患者因伤口感染而出现相当大的发病率。抗生素预防在这些手术中可能会有帮助。
