Feilmeier Mindi, Dayton Paul, Sedberry Shelly, Reimer Rachel A
Assistant Professor, Des Moines University College of Podiatric Medicine and Surgery, Des Moines, IA.
UnityPoint Clinic - Foot and Ankle Fort Dodge, Fort Dodge, IA; and Adjunct Professor, Des Moines University College of Podiatric Medicine and Surgery, Des Moines, IA.
J Foot Ankle Surg. 2014 Mar-Apr;53(2):173-5. doi: 10.1053/j.jfas.2013.12.021.
The incidence of postoperative surgical site infection (SSI) reported in the published data for foot and ankle surgery has been 1.0% to 5.3%. A variety of interventions have been used before, during, and after surgery to decrease the patient's risk of acquiring an infection at the surgical site. Foot and ankle surgeons often keep the incision site dry and covered until the sutures and pins have been removed, with the goal of preventing a SSI, despite the lack of available published evidence to support this practice. We undertook a prospective observation of 110 elective surgical patients to determine the rate of SSI when early surgical site exposure and showering were allowed. The risk factors for infection were recorded, and a series of logistic regression analyses was performed to determine the associations between the infection rate and early showering. The patients were evaluated at each postoperative appointment for signs of infection. For the present study, mild infection was defined as the subjective presence of erythema and/or swelling beyond that typically expected in the early postoperative period. These cases of presumed or mild SSI were managed with oral antibiotics until they had resolved. Major infection was defined as any infection altering the course of recovery or requiring admission or additional surgery. The overall infection rate was 4.5%, with all infections considered mild. Logistic regression analysis showed that none of the recorded risk factors significantly predicted infection. The results of the present study suggest that early daily showering of a surgical site after foot and ankle surgery will not be significantly associated with an increased risk of infection.
已发表的数据显示，足踝手术术后手术部位感染（SSI）的发生率为1.0%至5.3%。手术前、手术中和手术后已采用了多种干预措施，以降低患者发生手术部位感染的风险。尽管缺乏公开的证据支持，但足踝外科医生通常会保持切口部位干燥并覆盖，直到缝线和钢针拆除，目的是预防手术部位感染。我们对110例择期手术患者进行了前瞻性观察，以确定允许早期手术部位暴露和淋浴时的手术部位感染率。记录感染的风险因素，并进行一系列逻辑回归分析，以确定感染率与早期淋浴之间的关联。在每次术后复诊时对患者进行感染迹象评估。在本研究中，轻度感染定义为术后早期出现的红斑和/或肿胀超过预期。这些疑似或轻度手术部位感染的病例采用口服抗生素治疗，直至痊愈。严重感染定义为任何改变恢复过程或需要住院或进行额外手术的感染。总体感染率为4.5%，所有感染均为轻度。逻辑回归分析表明，记录的风险因素均未显著预测感染。本研究结果表明，足踝手术后手术部位早期每日淋浴与感染风险增加无显著关联。
