银尼龙在预防结肠和直肠手术后手术部位感染中的应用。

The use of silver nylon in preventing surgical site infections following colon and rectal surgery.

机构信息

Department of Surgery, Division of Colon and Rectal Surgery, University of South Florida, Tampa, Florida, USA.

出版信息

Dis Colon Rectum. 2011 Aug;54(8):1014-9. doi: 10.1097/DCR.0b013e31821c495d.

DOI:10.1097/DCR.0b013e31821c495d

PMID:21730792

Abstract

BACKGROUND

Patients who undergo colorectal surgery have up to a 30% chance of developing a surgical site infection postoperatively. Silverlon is a silver nylon dressing designed to prevent surgical site infections, but only anecdotal evidence has previously supported its efficacy.

OBJECTIVE

The aim of this study was to evaluate the effect of silver nylon dressings in patients undergoing colorectal surgery.

DESIGN

We performed a prospective, randomized, controlled trial comparing a silver nylon dressing with gauze dressings in patients undergoing elective colorectal surgery.

SETTING

The study was performed at a university-based, tertiary referral center.

PATIENTS

We studied patients undergoing elective colorectal surgery with an abdominal skin incision of at least 3 cm.

INTERVENTION

Patients were randomly assigned to receive either a silver nylon or a gauze dressing.

MAIN OUTCOME MEASURES

The primary end point was surgical site infection occurring within 30 days of surgery.

RESULTS

One hundred ten patients were enrolled in the study and were randomly assigned to 1 of 2 treatment groups. After a 30-day follow-up period, the incidence of surgical site infection was lower in the silver nylon group compared with the control group (13% vs 33%, P = .011). Twenty-five patients in the study developed superficial surgical site infections, 5 in the silver nylon group and 14 in the control group (P = .021). Two patients in the study group developed deep wound infections compared with 4 in the control group (P = .438). Multivariate analysis revealed that patients in the control group had a 3-fold increase in risk of infection compared with patients in the silver nylon group (P = .013).

LIMITATIONS

A limitation of this study is that the members of the surgical team were not blinded to the treatment groups.

CONCLUSION

Silver nylon is safe and effective in preventing surgical site infection following colorectal surgery.

摘要

背景

接受结直肠手术的患者术后发生手术部位感染的几率高达 30%。Silverlon 是一种银尼龙敷料，旨在预防手术部位感染，但之前只有一些传闻证据支持其疗效。

目的

本研究旨在评估在接受结直肠手术的患者中使用银尼龙敷料的效果。

设计

我们进行了一项前瞻性、随机、对照试验，比较了银尼龙敷料和纱布敷料在择期结直肠手术患者中的应用。

设置

该研究在一家大学附属的三级转诊中心进行。

患者

我们研究了接受择期结直肠手术且腹部皮肤切口至少 3 厘米的患者。

干预措施

患者被随机分配接受银尼龙或纱布敷料。

主要观察终点

术后 30 天内发生手术部位感染。

结果

110 例患者入组研究并随机分为 2 组治疗。在 30 天的随访期后，银尼龙组的手术部位感染发生率低于对照组（13%比 33%，P =.011）。研究中有 25 例患者发生浅表手术部位感染，银尼龙组 5 例，对照组 14 例（P =.021）。研究组中有 2 例患者发生深部伤口感染，对照组中有 4 例（P =.438）。多变量分析显示，与银尼龙组相比，对照组患者感染风险增加 3 倍（P =.013）。