Karapınar Kemal, Kocatürk Celalettin İbrahim
Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
Biomed Res Int. 2019 Feb 11;2019:1438793. doi: 10.1155/2019/1438793. eCollection 2019.
The rate of surgical site infections (SSIs) has decreased in parallel to advances in sterilization techniques. Such infections increase morbidity and hospitalization costs. The use of iodine-impregnated sterile wound drapes (SWDs) is recommended to prevent or reduce the incidence of these infections. However, there is a paucity of data regarding their use in thoracic surgical procedures. The aim of the present study was to evaluate the effectiveness of sterile wound drapes in the prevention of these infections and the effects on hospitalization costs.
Perioperative iodine-impregnated SWDs have been used since January 2015 in the Thoracic Surgery Clinic of our hospital. A retrospective evaluation was made of patients who underwent anatomic pulmonary resection via thoracotomy with SWD in the period January 2015-2017, compared with a control group who underwent the same surgery without SWD in the 2-year period before January 2015. Factors that may have increased the risk of surgical site infection were documented and the occurrence of SSI was recorded from postoperative follow-up data. The cost analysis was performed as an important criterion to investigate the benefits of SWD.
Evaluation was made of 654 patients in the study group (n:380) using SWD, the operation time was significantly longer, and perioperative blood transfusion was significantly higher, whereas treatment costs (p=0.0001) and wound culture positivity (p=0.004) were significantly lower and less surgical wound debridement was performed (p=0.002).
The findings suggest that the use of sterile wound draping in thoracic surgery procedures reduces surgical site infections and hospitalization costs.
手术部位感染(SSIs)的发生率随着消毒技术的进步而下降。此类感染会增加发病率和住院费用。建议使用含碘无菌伤口敷料(SWDs)来预防或降低这些感染的发生率。然而,关于其在胸外科手术中的应用数据较少。本研究的目的是评估无菌伤口敷料在预防这些感染方面的有效性以及对住院费用的影响。
自2015年1月起,我院胸外科诊所开始使用围手术期含碘SWDs。对2015年1月至2017年期间通过开胸手术使用SWD进行解剖性肺切除术的患者进行回顾性评估,并与2015年1月前两年内未使用SWD进行相同手术的对照组进行比较。记录可能增加手术部位感染风险的因素,并从术后随访数据中记录SSI的发生情况。作为调查SWD益处的重要标准,进行了成本分析。
对研究组中654例使用SWD的患者(n = 380)进行评估,手术时间显著延长,围手术期输血显著增加,而治疗费用(p = 0.0001)和伤口培养阳性率(p = 0.004)显著降低,手术伤口清创术的实施次数较少(p = 0.002)。
研究结果表明,在胸外科手术中使用无菌伤口敷料可降低手术部位感染和住院费用。