伤口感染与撕裂伤缝合时间之间有关系吗？

Is there a relationship between wound infections and laceration closure times?

作者信息

Waseem Muhammad, Lakdawala Viraj, Patel Rohit, Kapoor Ramnath, Leber Mark, Sun Xuming

机构信息

Department of Emergency Medicine, Lincoln Medical & Mental Health Center, 234 East 149th Street, Bronx, NY, 10451, USA.

出版信息

Int J Emerg Med. 2012 Jul 26;5(1):32. doi: 10.1186/1865-1380-5-32.

DOI:10.1186/1865-1380-5-32

PMID:22835090

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3414831/

Abstract

BACKGROUND

Lacerations account for a large number of ED visits. Is there a "golden period" beyond which lacerations should not be repaired primarily? What type of relationship exists between time of repair and wound infection rates? Is it linear or exponential? Currently, the influence of laceration age on the risk of infection in simple lacerations repaired is not clearly defined. We conducted this study to determine the influence of time of primary wound closure on the infection rate.

METHODS

This is a prospective observational study of patients who presented to the Emergency Department (ED) with a laceration requiring closure from April 2009 to November 2010. The wound closure time was defined as the time interval from when the patient reported laceration occurred until the time of the start of the wound repair procedure. Univariate analysis was performed to determine the factors predictive of infection. A non-parametric Wilcoxon rank-sum test was performed to compare the median differences of time of laceration repair. Chi-square (Fisher's exact) tests were performed to test for infection differences with regard to gender, race, location of laceration, mechanism of injury, co-morbidities, type of anesthesia and type of suture material used.

RESULTS

Over the study period, 297 participants met the inclusion criteria and were followed. Of the included participants, 224 (75.4%) were male and 73 (24.6%) were female. Ten patients (3.4%) developed a wound infection. Of these infections, five occurred on hands, four on extremities (not hands) and one on the face. One of these patients was African American, seven were Hispanic and two were Caucasian (p = 0.0005). Median wound closure time in the infection group was 867 min and in the non-infection group 330 min (p = 0.03).

CONCLUSIONS

Without controlling various confounding factors, the median wound closure time for the lacerations in the wound infection group was statistically significantly longer than in the non-infection group.

摘要

背景

撕裂伤导致大量患者前往急诊科就诊。是否存在一个“黄金期”，超过这个时间就不应再进行一期撕裂伤修复？修复时间与伤口感染率之间存在何种关系？是线性关系还是指数关系？目前，撕裂伤时长对单纯撕裂伤修复后感染风险的影响尚不明确。我们开展这项研究以确定一期伤口缝合时间对感染率的影响。

方法

这是一项对2009年4月至2010年11月因撕裂伤需缝合而前往急诊科就诊的患者进行的前瞻性观察研究。伤口缝合时间定义为从患者报告发生撕裂伤到伤口修复手术开始的时间间隔。进行单因素分析以确定感染的预测因素。采用非参数Wilcoxon秩和检验比较撕裂伤修复时间的中位数差异。进行卡方（Fisher精确）检验以检测性别、种族、撕裂伤部位、损伤机制、合并症、麻醉类型和所用缝合材料类型方面的感染差异。

结果

在研究期间，297名参与者符合纳入标准并接受随访。纳入的参与者中，224名（75.4%）为男性，73名（24.6%）为女性。10名患者（3.4%）发生伤口感染。在这些感染病例中，5例发生在手部，4例发生在四肢（非手部），1例发生在面部。这些患者中1例为非裔美国人，7例为西班牙裔，2例为白种人（p = 0.0005）。感染组伤口缝合时间中位数为867分钟，非感染组为330分钟（p = 0.03）。