Department of Thoracic and Vascular Surgery, North Karelia Central Hospital, Joensuu, Finland.
Scand J Surg. 2010;99(3):167-72. doi: 10.1177/145749691009900312.
this multicenter prospective observational study defined the incidence and risk factors of surgical wound infections (SWI) after infrarenal aortic and lower limb vascular surgery procedures and evaluated the severity and costs of these infections.
the study cohort comprised of 184 consecutive patients. Postoperative complications were recorded. The additional costs attributable to SWI were calculated.
Eighty-four (46%) patients had critical ischaemia, 81 (45%) patients underwent infrainguinal bypass surgery and 64 (35%) received vascular prosthesis or prosthetic patch. Forty-nine (27%) patients developed SWI. Staphylococcus aureus was the leading pathogen cultured from the wound. Forty-seven of the 49 infected wounds responded to and healed with the treatment. SWI was the cause of one major amputation. Independent predictors for SWI were infrainguinal surgery (OR 7.2, 95% Cl 2.92-17.65, p < 0.001), obesity (OR 6.1, 95% Cl 2.44-15.16, p < 0.001) and arteriography injection site within the operative area (OR 2.5, 95% Cl 1.13-5.48, p = 0.02). The average cost attributable to SWI was 3320 Ä.
the incidence of SWI after vascular surgery is high. The risk factors for SWI are infrainguinal surgery, obesity and arteriography injection site within the operative area. SWI increases morbidity and costs of operative treatment.
本多中心前瞻性观察研究定义了肾下主动脉和下肢血管手术后手术部位感染（SWI）的发生率和危险因素，并评估了这些感染的严重程度和成本。
研究队列包括 184 例连续患者。记录术后并发症。计算了归因于 SWI 的额外成本。
84 例（46%）患者有严重缺血，81 例（45%）患者进行了下肢旁路手术，64 例（35%）患者接受了血管假体或假体补丁。49 例（27%）患者发生了 SWI。从伤口培养出的主要病原体是金黄色葡萄球菌。49 例感染伤口中的 47 例经治疗后愈合。SWI 导致 1 例主要截肢。SWI 的独立预测因素为下肢手术（OR 7.2，95%CI 2.92-17.65，p<0.001）、肥胖（OR 6.1，95%CI 2.44-15.16，p<0.001）和术区动脉造影注射部位（OR 2.5，95%CI 1.13-5.48，p=0.02）。归因于 SWI 的平均成本为 3320 Ä。
血管手术后 SWI 的发生率很高。SWI 的危险因素是下肢手术、肥胖和术区动脉造影注射部位。SWI 增加了手术治疗的发病率和成本。
