University Department of Surgery at Fremantle Hospital and Royal Perth Hospital, Perth, Western Australia.
Colorectal Dis. 1999 Sep;1(5):267-71. doi: 10.1046/j.1463-1318.1999.00066.x.
Wound infection has been proposed as a key indicator of clinical outcome after colorectal surgery. The aim of this study was to identify risk factors that were associated with wound infections in patients undergoing either emergency or elective colonic resections.
We prospectively evaluated 251 patients admitted to Royal Perth Hospital over a 12-month period. All patients received prophylactic peri-operative antibiotics and were reviewed for 6 weeks post-operatively. Wound infection was defined as either the presence of pus or a serous discharge containing pathogenic bacteria. We evaluated the relationship between 40 independent variables and the incidence of wound infection.
There were 124 males and 127 females, of median age 68 years (range 14-90 years). The overall incidence of wound infection was 12%. Multiple logistic regression identified the presence of shock (odds ratio (OR) 14.6, P=0.05), atelectasis (OR 3.9, P=0.02), and number of days on antibiotics before surgery (OR 1.2, P=0.02) as significant independent variables.
These results suggest that the factors which were most often associated with wound infection were those that are indicative of either extensive disease or poor general health. The presence of a stoma and colonic perforation were not strong independent associations with wound infection.
伤口感染被认为是结直肠手术后临床结果的关键指标。本研究旨在确定与急症或择期结肠切除术患者伤口感染相关的风险因素。
我们前瞻性评估了在 12 个月期间入住皇家珀斯医院的 251 名患者。所有患者均接受预防性围手术期抗生素治疗，并在术后 6 周内进行复查。伤口感染定义为存在脓液或含有病原菌的浆液性分泌物。我们评估了 40 个独立变量与伤口感染发生率之间的关系。
男性 124 例，女性 127 例，中位年龄 68 岁（范围 14-90 岁）。伤口感染的总发生率为 12%。多变量逻辑回归确定休克（比值比 (OR) 14.6，P=0.05）、肺不张（OR 3.9，P=0.02）和手术前使用抗生素的天数（OR 1.2，P=0.02）是显著的独立变量。
这些结果表明，与伤口感染最相关的因素通常是广泛疾病或一般健康状况不佳的指标。造口和结肠穿孔与伤口感染无明显独立相关性。
