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手术伤口管理变得更轻松且更具成本效益。

Surgical wound management made easier and more cost-effective.

作者信息

Akagi Ichiro, Furukawa Kiyonori, Miyashita Masao, Kiyama Teruo, Matsuda Akihisa, Nomura Tsutomu, Makino Hiroshi, Hagiwara Nobutoshi, Takahashi Ken, Uchida Eiji

机构信息

Division of Surgery for Organ Function and Biological Regulation, Nippon Medical School, Tokyo, Japan.

出版信息

Oncol Lett. 2012 Jul;4(1):97-100. doi: 10.3892/ol.2012.687. Epub 2012 Apr 19.

Abstract

Evidence-based guidelines for the prevention of surgical site infection (SSI) have been published by the U.S. Centers for Disease Control and Prevention (CDC). According to these guidelines, a wound should usually be covered with a sterile dressing for 24 to 48 h when a surgical incision is closed primarily. However, it is not recommended that an incision be covered by a dressing beyond 48 h. In this study, patients were stratified into two groups for analysis: patients whose surgical wound was sterilized and whose gauze was changed once daily until postoperative day 7 (7POD; group A); and patients whose surgical wound was sterilized and whose gauze was changed once daily until 2POD (group B). We evaluated the incidence of SSI, nursing hours and cost implications. The results showed that there was no significant difference in SSI occurrence between the two groups (group A, 10% vs. group B, 7.3%). By contrast, the average nursing time differed by 2.8 min (group A, 3.8 min vs. group B, 0.9 min). The material costs per patient were also reduced by $14.70 (group A, $61.80 vs. group B, $47.10). In conclusion, we applied our knowledge of the evidence-based CDC guidelines to determine whether 48-h wound management can be made easier, more uniform and more cost-effective compared to conventional wound management. The results of the present study showed that surgical wound management methods can be more convenient and inexpensive.

摘要

美国疾病控制与预防中心(CDC)已发布了预防手术部位感染(SSI)的循证指南。根据这些指南,当手术切口一期缝合时,伤口通常应使用无菌敷料覆盖24至48小时。然而,不建议在48小时后仍用敷料覆盖切口。在本研究中,患者被分为两组进行分析:手术伤口消毒且每天更换一次纱布直至术后第7天(7POD;A组)的患者;以及手术伤口消毒且每天更换一次纱布直至术后第2天(B组)的患者。我们评估了SSI的发生率、护理时长和成本影响。结果显示,两组之间SSI的发生率无显著差异(A组为10%,B组为7.3%)。相比之下,平均护理时间相差2.8分钟(A组为3.8分钟,B组为0.9分钟)。每位患者的材料成本也降低了14.70美元(A组为61.80美元,B组为47.10美元)。总之,我们运用循证CDC指南的知识来确定与传统伤口管理相比,48小时的伤口管理是否可以更轻松、更统一且更具成本效益。本研究结果表明,手术伤口管理方法可以更便捷且成本更低。

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