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灾害相关损伤管理:超级台风海燕过后伤口感染的高发生率

Disaster-Related Injury Management: High Prevalence of Wound Infection After Super Typhoon Haiyan.

作者信息

Kim Yong Won, Kim Seong Yeop, Kim Hoon, Ahn Moo Eob, Lee Kang Hyun, Hong Eun Seok

机构信息

1Department of Emergency Medicine,Wonju College of Medicine,Yonsei University,Republic of Korea.

2Department of General Surgery,Wonju College of Medicine,Yonsei University,Republic of Korea.

出版信息

Disaster Med Public Health Prep. 2016 Feb;10(1):28-33. doi: 10.1017/dmp.2015.100. Epub 2015 Sep 2.

Abstract

BACKGROUND

After Super Typhoon Haiyan, a category 5 tropical cyclone, insufficient resources were available for medical management. Many patients in the Philippines were wounded as a result of the disaster. We examined the prevalence, risk factors, and consequences of disaster-related wounds and wound infection in the post-disaster period.

METHODS

We performed a retrospective review of consecutive patients admitted to a Korean Disaster Relief Team clinic at St. Paul's Hospital, Tacloban City, Republic of Philippines, between December 9 and 13, 2013. Traumatic injury patients were included; patients not exhibiting a wound were excluded.

RESULTS

Of the 160 patients enrolled in the study, 71 (44.4%) had infected wounds. There were no significant differences in the age, sex, past medical history, wound site, wound depth, injury mechanism, or inducer of injury between the uninfected and infected groups. In the univariate analysis, a foreign-body-contaminated wound, a chronic wound, elapsed time from injury to medical contact, an inadequately cared for wound, and need for subsequent wound management were associated with wound infection (P<0.05). The multivariate analysis revealed that foreign body contamination and having an inadequately cared for wound were associated with wound infection (odds ratio [OR]: 10.12, 95% confidence interval [CI]: 3.59-28.56; OR: 3.51, 95% CI: 1.07-11.51, respectively).

CONCLUSION

In the post-disaster situation, many wound infections required definitive care. Wound infection was associated with inadequately cared for wounds and foreign-body-contaminated wounds.

摘要

背景

五级热带气旋“海燕”超强台风过后,医疗救治资源匮乏。菲律宾许多患者因这场灾难而受伤。我们调查了灾后与灾难相关伤口及伤口感染的患病率、危险因素和后果。

方法

我们对2013年12月9日至13日期间入住菲律宾共和国塔克洛班市圣保罗医院韩国救灾医疗队诊所的连续患者进行了回顾性研究。纳入创伤患者;排除未出现伤口的患者。

结果

在纳入研究的160例患者中,71例(44.4%)伤口感染。未感染组和感染组在年龄、性别、既往病史、伤口部位、伤口深度、损伤机制或致伤因素方面无显著差异。单因素分析显示,有异物污染伤口、慢性伤口、从受伤到就医的时间、伤口护理不当以及需要后续伤口处理与伤口感染相关(P<0.05)。多因素分析显示,异物污染和伤口护理不当与伤口感染相关(比值比[OR]:10.12,95%置信区间[CI]:3.59 - 28.56;OR:3.51,95%CI:1.07 - 11.51)。

结论

在灾后情况下,许多伤口感染需要确定性治疗。伤口感染与伤口护理不当和异物污染伤口有关。

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