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塑料切口巾能否防止腰椎手术期间内源性皮肤菌群的再定植?

Does Plastic Incise Drape Prevent Recolonization of Endogenous Skin Flora during Lumbar Spine Procedures?

作者信息

Zarei Mohammadreza, Larti Negin, Tabesh Homayoun, Ghasembandi Mohammad, Aarabi Akram

机构信息

Department of Operating Room, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Operating Room, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Int J Prev Med. 2019 Oct 9;10:162. doi: 10.4103/ijpvm.IJPVM_133_19. eCollection 2019.

Abstract

BACKGROUND

The aim of this study was to compare the PID with bare skin (without PID) regarding bacterial recolonization and bacterial regrowth of the adjacent skin of surgical incision in lumbar spine surgery patients.

METHODS

This quasi-experimental study was conducted from February to May 2018 on 88 patients who were candidate for lumbar spine surgery. Patients were assigned to one of two groups, treatment (with PID) and control (without PID). Skin sampling (adjacent of surgical incision) for bacterial culture was done in two steps, immediately after surgical skin prep (IASSP) and immediately after surgical wound closure (IASWC) by researcher. Finally, samples were sent to the laboratory.

RESULTS

The mean total bacterial count of patient's skin in stage IASSP was not significantly different between treatment and control groups (0.34 vs 0.27, = 0.68). However, mean total bacterial count in stage IASWC in treatment group was significantly higher than control group (2.2 vs 0.93, = 0.03). The frequency distribution of ( = 0.04) and ( = 0.02) was significantly higher in treatment group compared with control group in stage IASWC.

CONCLUSIONS

The results showed that using PID is unable to reduce recolonization and regrowth of bacteria on patients' skin adjacent to surgical wound in clean lumbar spine surgeries. However, making a definite decision about using or not using of PID requires further studies.

摘要

背景

本研究的目的是比较腰椎手术患者中使用手术切口保护装置(PID)与裸露皮肤(不使用PID)时手术切口周围皮肤的细菌再定植和细菌再生长情况。

方法

本准实验研究于2018年2月至5月对88例拟行腰椎手术的患者进行。患者被分为两组,治疗组(使用PID)和对照组(不使用PID)。研究人员在手术皮肤准备后立即(IASSP)和手术伤口闭合后立即(IASWC)分两步对手术切口周围皮肤进行细菌培养采样。最后,将样本送检。

结果

在IASSP阶段,治疗组和对照组患者皮肤的平均总细菌计数无显著差异(0.34对0.27,P = 0.68)。然而,在IASWC阶段,治疗组的平均总细菌计数显著高于对照组(2.2对0.93,P = 0.03)。在IASWC阶段,治疗组中金黄色葡萄球菌(P = 0.04)和凝固酶阴性葡萄球菌(P = 0.02)的频率分布显著高于对照组。

结论

结果表明,在清洁的腰椎手术中,使用PID无法减少手术伤口周围患者皮肤上细菌的再定植和再生长。然而,关于是否使用PID做出明确决定还需要进一步研究。

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