手术引流与手术部位感染的关系 - 一项前瞻性观察研究。
The association of surgical drains with surgical site infections - A prospective observational study.
机构信息
Department of Surgery, University of Basel and University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
Clinical Trial Unit, University of Basel and University Hospital Basel, Spitalstrasse 12, 4031, Basel, Switzerland.
出版信息
Am J Surg. 2019 Jan;217(1):17-23. doi: 10.1016/j.amjsurg.2018.06.015. Epub 2018 Jun 19.
BACKGROUND
Surgical drains are widely used despite limited evidence in their favor. This study describes the associations between drains and surgical site infections (SSI).
METHODS
This prospective observational double center study was performed in Switzerland between February 2013 and August 2015.
RESULTS
The odds of SSI in the presence of drains were increased in general (OR 2.41, 95%CI 1.32-4.30, p = 0.004), but less in vascular and not in orthopedic trauma surgery. In addition to the surgical division, the association between drains and SSI depended significantly on the duration of surgery (p = 0.01) and wound class (p = 0.034). Furthermore, the duration of drainage (OR 1.24, 95%CI 1.15-1.35, p < 0.001), the number (OR 1.74, 95%CI 1.09-2.74, p = 0.019) and type of drains (open versus closed: OR 3.68, 95%CI 1.88, 6.89, p < 0.001) as well as their location (overall p = 0.002) were significantly associated with SSI.
CONCLUSIONS
The general use of drains is discouraged. However, drains may be beneficial in specific surgical procedures.
背景
尽管引流术的疗效证据有限，但它仍被广泛应用。本研究旨在描述引流术与手术部位感染（SSI）之间的关系。
方法
本前瞻性观察性双中心研究于 2013 年 2 月至 2015 年 8 月在瑞士进行。
结果
存在引流时 SSI 的发生风险普遍增加（OR 2.41，95%CI 1.32-4.30，p=0.004），但在血管和骨科创伤手术中则不然。除手术切开外，引流与 SSI 之间的关联还与手术持续时间（p=0.01）和伤口类型（p=0.034）显著相关。此外，引流持续时间（OR 1.24，95%CI 1.15-1.35，p<0.001）、引流管数量（OR 1.74，95%CI 1.09-2.74，p=0.019）和类型（开放型与密闭型：OR 3.68，95%CI 1.88-6.89，p<0.001）以及引流位置（总体 p=0.002）与 SSI 显著相关。
结论
不鼓励常规使用引流术。然而，在某些特定的手术中，引流可能是有益的。
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