Department of Vascular and Endovascular Surgery, PMU Salzburg, Müllner Hauptstrasse 48, A-5020 Salzburg, Austria.
Eur J Vasc Endovasc Surg. 2012 May;43(5):561-6. doi: 10.1016/j.ejvs.2012.01.030. Epub 2012 Mar 3.
Surgical site infections (SSIs) after bypass procedures provoke major costs. The aim of this prospective randomised trial was to assess if preoperative duplex vein mapping (DVM) reduces costs generated by SSI.
MATERIALS/METHODS: Patients undergoing primary infrainguinal bypass were randomised to DVM of the ipsilateral greater saphenous vein (group A) or none (group B). Costs were calculated by the hospital's accounting department.
From December 2009 to April 2011, 130 patients (65 each group) were enrolled. Both cohorts were equal regarding demographics, risk factors and costs for primary bypass surgery, respectively. SSIs were classified minor (A: n = 13 vs. B: n = 13, P = n.s.) and major (A: n = 1 vs. B: n = 12, P = .0154). Preoperative DVM was the only significant factor to prevent major SSI (P = .011). Theatre costs for SSI: A: 537 € versus B 6553 € (P = .16). Recovery room/intensive care unit (ICU) costs for SSI: A: 0 € versus B: 8016 € (P = .22). Surgical ward costs for SSI: A: 2823 € versus B: 22 386 € (P = .011). Costs for outpatient visits due to SSI: A: 6265 € versus B: 12 831 € (P = .67). Total costs of patients without SSI: 8177 € versus major SSI: 10 963 € (P < .001).
DVM significantly reduces costs generated by re-admission in patients suffering from major SSI.
旁路手术后的手术部位感染（SSI）会带来重大成本。本前瞻性随机试验的目的是评估术前双功能静脉成像（DVM）是否可以降低 SSI 引起的成本。
材料/方法：接受原发性下肢旁路手术的患者被随机分为对侧大隐静脉 DVM 组（A 组）或无 DVM 组（B 组）。成本由医院的会计部门计算。
从 2009 年 12 月至 2011 年 4 月，共纳入 130 例患者（每组 65 例）。两组患者的人口统计学、危险因素和原发性旁路手术的成本分别相等。SSI 分为轻微（A 组：n=13 例，B 组：n=13 例，P=无统计学意义）和严重（A 组：n=1 例，B 组：n=12 例，P=0.0154）。术前 DVM 是预防严重 SSI 的唯一显著因素（P=0.011）。SSI 的手术室成本：A 组：537 欧元，B 组：6553 欧元（P=0.16）。SSI 的复苏室/重症监护病房（ICU）成本：A 组：0 欧元，B 组：8016 欧元（P=0.22）。SSI 的外科病房成本：A 组：2823 欧元，B 组：22386 欧元（P=0.011）。SSI 门诊就诊的费用：A 组：6265 欧元，B 组：12831 欧元（P=0.67）。无 SSI 的患者总费用：8177 欧元，严重 SSI：10963 欧元（P<0.001）。
DVM 可显著降低严重 SSI 患者再入院产生的成本。
