Smith Mitchell L, Gotmaker Robert, Hoy Greg A, Ek Eugene T, Carr Ashley, Flynn Jennifer N, Evans Matthew C
Department of Orthopaedics, Melbourne Orthopaedic Group, Melbourne, Victoria, Australia.
Department of Anaesthetics, St Vincent's Hospital, Melbourne, Victoria, Australia.
ANZ J Surg. 2018 Nov;88(11):1178-1181. doi: 10.1111/ans.14821. Epub 2018 Sep 21.
Propionibacterium acnes may be transmitted from the subdermal tissues to the deeper tissues during shoulder arthroplasty surgery, resulting in deep infection. The aim of this prospective, clinical study was to determine whether the use of a wound protector drape can lower the incidence of P. acnes in the wound during shoulder arthroplasty surgery.
For a consecutive series of 47 patients undergoing shoulder arthroplasty, a wound protector drape was used during surgery, to isolate the subdermal layer from the surgeons' hands, retractors and other instruments. Microbiological swabs were taken both from the subdermal layer and the exposed drape to determine the incidence of P. acnes at both sites.
The overall incidence of P. acnes in the subdermal layer was 23%. A fivefold decrease in the incidence of P. acnes in the exposed superficial layer was demonstrated by use of the wound protector drape.
Use of a wound protector drape to isolate the superficial tissue layer from the surgeons' gloves, instruments and retractors decreases the incidence of P. acnes in the surgical field. This may result in a decreased rate of transmission to the deeper tissues, and a decreased rate of P. acnes deep infection.
痤疮丙酸杆菌可能在肩关节置换手术过程中从皮下组织传播至更深层组织，导致深部感染。这项前瞻性临床研究的目的是确定使用伤口保护单是否能降低肩关节置换手术期间伤口中痤疮丙酸杆菌的发生率。
对于连续47例行肩关节置换术的患者，手术期间使用伤口保护单，以将皮下层与外科医生的手、牵开器及其他器械隔离开。从皮下层和暴露的手术单上采集微生物拭子，以确定两个部位痤疮丙酸杆菌的发生率。
皮下层痤疮丙酸杆菌的总体发生率为23%。使用伤口保护单后，暴露的表层中痤疮丙酸杆菌的发生率降低了五倍。
使用伤口保护单将浅表组织层与外科医生的手套、器械和牵开器隔离开，可降低手术区域痤疮丙酸杆菌的发生率。这可能会导致向更深层组织的传播率降低，以及痤疮丙酸杆菌深部感染率降低。
