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氧化再生纤维素在预防手术部位感染中的作用:对98例受污染伤口患者的前瞻性随机研究。

Role of oxidized regenerated cellulose in preventing infections at the surgical site: prospective, randomized study in 98 patients affected by a dirty wound.

作者信息

Alfieri S, Di Miceli D, Menghi R, Quero G, Cina C, Pericoli Ridolfini M, Doglietto G

机构信息

Department of Digestive Surgery, Catholic University of Sacred Heart, Rome, Italy.

出版信息

Minerva Chir. 2011 Feb;66(1):55-62.

Abstract

AIM

The aim of this study was to evaluate whether oxidized regenerated cellulose (ORC), applied to "dirty" surgical wounds, is able to reduce the microbial load and, consequently, the infection rate as compared to conventional local wound treatment.

METHODS

The study included 98 patients who underwent intestinal recanalization procedures between December 2003 and December 2008, with the stoma as the surgical site. Authors considered several risk factors for SSI. The patients were divided into two groups. In group A (50 patients), the surgical wound, previous site of the stoma, was packed with ORC, whereas in group B (48 patients) gauze soaked in iodine was used. Microbial contamination was evaluated with three swabs (in subcutaneous tissue and the dermis), in the operating room before wound packing and on the 2nd and 3rd postoperative day (before suturing the skin).

RESULTS

There were no cases of wound dehiscence and no clinically evident superficial or deep surgical site infections in either group. Analysis of all data revealed that there was no or reduced bacterial contamination in the second and third swab in 33 patients (66%) of Group A versus 12 patients (25%) of Group B.

CONCLUSION

Although it is necessary to consider all factors which can have an influence on SSI and use all the means shown to be effective to reduce the risk of SSI, there is a rationale for using ORC to prevent this kind of infection, especially in patients who undergo "dirty" surgery.

摘要

目的

本研究旨在评估与传统局部伤口处理相比,应用于“污染”手术伤口的氧化再生纤维素(ORC)是否能够降低微生物负荷,从而降低感染率。

方法

该研究纳入了98例在2003年12月至2008年12月期间接受肠道再通手术且以造口为手术部位的患者。作者考虑了手术部位感染(SSI)的几个风险因素。将患者分为两组。A组(50例患者),将ORC填充于手术伤口(先前的造口部位),而B组(48例患者)使用浸有碘的纱布。在手术室伤口填充前以及术后第2天和第3天(皮肤缝合前),用三根拭子(在皮下组织和真皮中)评估微生物污染情况。

结果

两组均无伤口裂开病例,也无临床明显的浅表或深部手术部位感染。对所有数据的分析显示,A组33例患者(66%)在第二根和第三根拭子中的细菌污染无或减少,而B组为12例患者(25%)。

结论

尽管有必要考虑所有可能影响手术部位感染的因素,并使用所有已证明有效的方法来降低手术部位感染的风险,但有理由使用ORC来预防此类感染,尤其是在接受“污染”手术的患者中。

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