Department of Orthopaedic Surgery, Aichi Medical University, Nagakute, Japan.
Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Ichinomiya, Japan.
Nagoya J Med Sci. 2021 Feb;83(1):151-157. doi: 10.18999/nagjms.83.1.151.
In recent years, has been reported to affect postoperative outcomes. The purpose of this study was to examine the detection rate and clinical features of infection after open shoulder surgery. Fifty-nine patients (33 males and 26 females; mean age, 69.1 years) were included. Samples were collected from a skin swab at the incision site prior to skin preparation. Further samples were collected from synovial swabs at the glenohumeral joint immediately after incision and before incision closure. Samples with -positive skin swab cultures were defined as Group A, and those with negative cultures were defined as Group N. Age, sex, presence of diabetes mellitus, operation time, presence of deep infection after surgery, and rate of positive synovial swab cultures were compared between groups. There were 27 patients in Group A (mean age 69.1±13.3 [SD], 21 males and 6 females) and 32 patients in Group N (mean age 69.1±11.0 [SD], 12 males and 20 females). No significant difference in the presence of diabetes mellitus and operation time were found between groups. From the glenohumeral joint immediately after incision, was detected in 22.2% and 0% of patients in Group A and Group N, respectively. For the glenohumeral joint before incision closure, was detected in 22.2% and 0% of patients in Group A and Group N, respectively, demonstrating a significantly higher rate in Group A. Our findings suggest that the route of infection following open shoulder surgery is via contamination.
近年来，已有研究报道 会影响肩关节手术后的结局。本研究旨在探讨肩关节切开术后 感染的检出率和临床特征。共纳入 59 例患者（男 33 例，女 26 例；平均年龄 69.1 岁）。在备皮前，于切口处采集皮肤拭子标本；切开后、关闭切口前，于盂肱关节处采集滑膜拭子标本。皮肤拭子培养 -阳性的患者归入 A 组，培养 -阴性的归入 N 组。比较两组患者的年龄、性别、是否合并糖尿病、手术时间、术后深部感染发生情况，以及滑膜拭子培养的阳性率。A 组 27 例（男 21 例，女 6 例；平均年龄 69.1±13.3 岁），N 组 32 例（男 12 例，女 20 例；平均年龄 69.1±11.0 岁）。两组患者的糖尿病患病率、手术时间比较，差异均无统计学意义（均 P＞0.05）。A 组患者于切开后即刻关节腔滑膜拭子培养的阳性率为 22.2%，N 组为 0%；A 组患者于关闭切口前关节腔滑膜拭子培养的阳性率为 22.2%，N 组为 0%，A 组的阳性率显著高于 N 组。本研究结果表明，肩关节切开术后的感染途径为污染。
