Jiang Yugang, Chen Hongyuan, Liu Guotao, Liu Meifeng, Kong Meng, Sheng Hongguang
Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Front Surg. 2022 Jul 26;9:917559. doi: 10.3389/fsurg.2022.917559. eCollection 2022.
Colorectal surgery is associated with a high risk of surgical site infection (SSI). In March 2017, we developed an intervention, called "PRESS", with the aim of reducing colorectal superficial SSI. This study assessed the effect of the new intervention in reducing the rates of superficial SSI in colorectal surgery.
This study was a retrospective review of 312 PRESS+ patients compared to 171 historical control PRESS- patients who were 18 years of age or older and underwent elective colorectal surgery with clean-contaminated wounds from January 2015 to June 2020. In the PRESS+ groups, we pressed the incision downward hard with clean gauze after the interrupted suturing of the skin. Propensity score matching with 15 variables was performed in a 1:1 ratio to reduce selection bias. Univariate analysis and multivariate analysis were performed to identify risk factors associated with SSI.
The characteristics of the PRESS+ ( = 160) and PRESS- ( = 160) groups were well balanced after propensity score matching. The PRESS+ group had a lower superficial SSI rate (1.9% vs. 6.9%, = 0.029) and a lower overall SSI rate (2.5% vs. 10.0%, = 0.006) than the PRESS- group. Furthermore, multivariate analysis showed that the incisional press was an effective protective factor for superficial SSI (adjusted odds ratio = 0.215, 95% confidence interval = 0.057-0.818, = 0.024). In addition, female sex ( = 0.048) and blood transfusion ( = 0.011) were demonstrated to be independent risk factors for superficial SSI.
The incisional press after suturing is a simple, costless, and effective intervention in reducing superficial incisional SSI.
结直肠手术与手术部位感染（SSI）的高风险相关。2017年3月，我们开发了一种名为“PRESS”的干预措施，旨在降低结直肠浅表SSI。本研究评估了这种新干预措施在降低结直肠手术浅表SSI发生率方面的效果。
本研究对312例接受PRESS干预的患者与171例历史对照的未接受PRESS干预的患者进行回顾性分析，这些患者年龄在18岁及以上，于2015年1月至2020年6月期间接受了清洁-污染伤口的择期结直肠手术。在接受PRESS干预的组中，皮肤间断缝合后，我们用干净纱布用力向下按压切口。进行1:1比例的15个变量的倾向得分匹配以减少选择偏倚。进行单因素分析和多因素分析以确定与SSI相关的危险因素。
倾向得分匹配后，接受PRESS干预组（n = 160）和未接受PRESS干预组（n = 160）的特征得到了很好的平衡。接受PRESS干预组的浅表SSI发生率较低（1.9%对6.9%，P = 0.029），总体SSI发生率也较低（2.5%对10.0%，P = 0.006）。此外，多因素分析表明，切口按压是浅表SSI的有效保护因素（调整后的优势比 = 0.215，95%置信区间 = 0.057 - 0.818，P = 0.024）。此外，女性（P = 0.048）和输血（P = 0.011）被证明是浅表SSI的独立危险因素。
缝合后切口按压是一种简单、无成本且有效的降低浅表切口SSI的干预措施。
