Uzuka Takeo, Takahashi Hideaki, Nakasu Yoko, Okuda Takeshi, Mitsuya Koichi, Hayashi Nakamasa, Hirose Takayuki, Kurai Hanako
Department of Neurosurgery, Niigata Cancer Center Hospital.
Department of Neurosurgery, Dokkyo Medical University.
Neurol Med Chir (Tokyo). 2017 Oct 15;57(10):542-547. doi: 10.2176/nmc.oa.2017-0034. Epub 2017 Jul 26.
Patients with malignant brain tumors are possibly at increased risk for surgical site infections (SSIs) considering the various medical situations associated with the disease. However, the actual rate of SSI after malignant brain tumor resection has not been well established, despite the potential impact of SSI on patient outcome. To investigate the incidence of SSI following malignant brain tumor surgery, we performed a retrospective study in 3 neurosurgical units. Subsequently, aiming at the reduction of incidence of SSI, we performed a prospective study using a care bundle technique in the same units. The SSI incidence in the retrospective (n = 161) and prospective studies (n = 68) were 4.3% and 4.4%, respectively, similar to the previously reports on general craniotomies. A care bundle does not appear to enhance prevention of SSI. However, future, large studies with a new care bundle should be planned based on a zero tolerance policy.
考虑到与恶性脑肿瘤相关的各种医疗情况,患有恶性脑肿瘤的患者可能面临手术部位感染(SSIs)风险增加的问题。然而,尽管手术部位感染对患者预后有潜在影响,但恶性脑肿瘤切除术后手术部位感染的实际发生率尚未得到很好的确立。为了调查恶性脑肿瘤手术后手术部位感染的发生率,我们在3个神经外科单元进行了一项回顾性研究。随后,为了降低手术部位感染的发生率,我们在同一单元使用护理包技术进行了一项前瞻性研究。回顾性研究(n = 161)和前瞻性研究(n = 68)中的手术部位感染发生率分别为4.3%和4.4%,与之前关于普通开颅手术的报告相似。护理包似乎并不能增强对手术部位感染的预防。然而,未来应基于零容忍政策规划采用新护理包的大型研究。