Division of Nursing Education, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Neurol India. 2011 Jan-Feb;59(1):12-7. doi: 10.4103/0028-3886.76850.
Controlled studies on the effect of alcohol-based hand rub before and after each patient contact on surgical site infection (SSI) among neurosurgical patients are scarce. Aim : To evaluate the effect of alcohol-based hand rub before and after each patient contact on SSI after elective neurosurgical procedures.
Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala. An intervention study using a 'before-after' design.
Two 9-month study periods were compared; between these periods, an infection-control protocol incorporating an alcohol-based hand rub was implemented for a period of 3 months and continued thereafter. Consecutive patients who underwent neurosurgery between January and September 2006 (control group, before protocol) and between January and September 2007 (intervention group, after protocol) were included. Outcome measures included SSI rates, profile of microorganisms and patient survival. Statistical Analysis : SPSS statistics version 17.0.
A total of 1,899 operated cases were reviewed. The patients in the control and intervention groups were similar with regard to sex, age and type of neurosurgery. The surgical site infection rates were 22 (2.3%) out of 974 in the control group and 14 (1.5%) out of 925 in the intervention group (P = 0.2). Patient survival rates were 97.6% (control) and 98.3% (intervention). Post hoc power calculation for an alpha value equal to 0.05, the power obtained was 24.9%, showing inadequacy of sample size to get significant results. To achieve 80% power, the sample size required is about 4,800 each for the control and intervention groups.
Use of alcohol-based hand rub before and after each patient contact in the neurosurgical intensive care unit did not show a significant reduction in SSI in the present study. This lack of difference between the two groups may be related to the inadequate sample size. The other possibility is that both the strategies are of equal efficacy for prevention of SSIs.
针对接触每位患者前后使用含酒精的洗手液对手部进行清洁对神经外科患者手术部位感染（SSI）的影响，目前仅有少量对照研究。目的：评估接触每位患者前后使用含酒精的洗手液对择期神经外科手术后 SSI 的影响。
喀拉拉邦特里凡得琅的 Sree Chitra Tirunal 医学科学与技术研究所神经外科。采用“前后”设计的干预研究。
比较了两个为期 9 个月的研究期；在此期间，实施了一项感染控制方案，其中包含 3 个月的含酒精洗手液使用，并在此后继续实施。纳入 2006 年 1 月至 9 月（对照组，方案实施前）和 2007 年 1 月至 9 月（干预组，方案实施后）期间接受神经外科手术的连续患者。观察指标包括 SSI 发生率、微生物谱和患者生存率。统计分析：SPSS statistics 版本 17.0。
共回顾了 1899 例手术患者。对照组和干预组在性别、年龄和神经外科类型方面相似。对照组 974 例中有 22 例（2.3%）发生手术部位感染，干预组 925 例中有 14 例（1.5%）（P=0.2）。患者生存率为 97.6%（对照组）和 98.3%（干预组）。α 值等于 0.05 时的事后功效计算显示，样本量不足，无法得出显著结果。要获得 80%的功效，对照组和干预组分别需要大约 4800 个样本。
本研究中，在神经外科重症监护病房接触每位患者前后使用含酒精的洗手液并未显著降低 SSI。这两组之间没有差异可能与样本量不足有关。另一种可能性是，这两种策略对预防 SSI 的效果相同。
