Department of Health Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
J Hosp Infect. 2010 Jul;75(3):183-7. doi: 10.1016/j.jhin.2010.01.021.
A large scale survey was conducted to examine risk factors for surgical site infections (SSIs) among Japanese patients undergoing gastrointestinal surgery. The purposes of the study were: (i) to investigate age as a risk factor for SSIs in gastrointestinal surgery; and (ii) to examine the differences in risk factors for SSIs between laparoscopic cholecystectomy and open cholecystectomy. Surveillance data were prospectively collected from 20 participating hospitals in Japan between July 2003 and November 2007. SSIs were identified by use of the Centers for Disease Control and Prevention criteria. SSIs were identified in 1471 of 12 015 available cases, with an overall incidence of 12.2%. In the final logistic regression model, age was a risk factor in open cholecystectomy, gastrectomy and appendicectomy. Length of operation was a risk factor for SSIs for six surgical procedures, and wound class and drain use were also risk factors in most procedures. When comparing laparoscopic surgery against open procedure, use of silk sutures was a risk factor for SSIs in laparoscopic cholecystectomy. Drain use, wound class, operation duration, male gender and age were additional risk factors for SSIs in open cholecystectomy. In summary, patient age is a significant predictor for SSIs in some gastrointestinal procedures, although risk factors for SSIs in laparoscopic procedures appear quite different from those in open procedures.
一项大规模调查旨在研究日本胃肠道手术患者发生手术部位感染（SSI）的危险因素。本研究的目的是：（i）调查年龄作为胃肠道手术 SSI 的危险因素；（ii）研究腹腔镜胆囊切除术和开腹胆囊切除术之间 SSI 危险因素的差异。2003 年 7 月至 2007 年 11 月，日本 20 家参与医院前瞻性收集了监测数据。采用美国疾病控制与预防中心的标准确定 SSI。在 12015 例可评估病例中，1471 例发生 SSI，总发生率为 12.2%。在最终的逻辑回归模型中，年龄是开腹胆囊切除术、胃癌手术和阑尾切除术的危险因素。手术时间是 6 种手术 SSI 的危险因素，而伤口类别和引流的使用也是大多数手术的危险因素。与开腹手术相比，腹腔镜胆囊切除术中使用丝线缝合是 SSI 的危险因素。引流、伤口类别、手术时间、性别和年龄是开腹胆囊切除术 SSI 的其他危险因素。总之，患者年龄是某些胃肠道手术 SSI 的显著预测因素，尽管腹腔镜手术 SSI 的危险因素与开腹手术的危险因素明显不同。
