手术护理综合措施对非重建性乳腺癌手术后手术部位感染的影响：一项单中心回顾性比较队列研究

Impact of Surgical Care Bundle on Surgical Site Infection after Non-Reconstructive Breast Cancer Surgery: A Single-Centre Retrospective Comparative Cohort Study.

作者信息

Chin Kian, Wärnberg Fredrik, Kovacs Anikó, Olofsson Bagge Roger

机构信息

Department of Surgery, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden.

Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden.

出版信息

Cancers (Basel). 2023 Feb 1;15(3):919. doi: 10.3390/cancers15030919.

DOI:10.3390/cancers15030919

PMID:36765876

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9913200/

Abstract

BACKGROUND

Surgical-site infections (SSIs) are the commonest cause of healthcare-related infections. Although a surgical care bundle (SCB), defined as a group of preventative measures, is effective in reducing SSIs, it has not been well documented in breast cancer surgery. We aimed to investigate the impact of SCB on SSI.

METHODS

A single-centre retrospective comparative cohort study between 2016 and 2020 was carried out. An SCB including eight different measures was implemented in October 2018 at Sahlgrenska University Hospital, Sweden. Patients who underwent non-reconstructive breast cancer surgery were included for analysis. The primary endpoint was SSI within 30 days after surgery.

RESULTS

Overall, 10.4% of patients (100/958) developed SSI. After SCB implementation, the overall SSI rate reduced from 11.8% to 8.9% ( = 0.15). The largest SSI rate reduction was seen in the subgroup that underwent breast conservation and sentinel lymph node biopsy (SLNB), from 18.8% to 9.8% ( = 0.01). In this multivariable analysis adjusting for patient and treatment factors, the implementation of SCB resulted in a statistically significant reduction in SSI risk (OR 0.63, 95% CI 0.40-0.99, = 0.04).

CONCLUSIONS

The implementation of a SCB could reduce the incidence of SSI in breast cancer surgery.

摘要

背景

手术部位感染（SSIs）是医疗相关感染最常见的原因。虽然手术护理包（SCB），即一组预防措施，在降低手术部位感染方面是有效的，但在乳腺癌手术中尚未得到充分记录。我们旨在研究手术护理包对手术部位感染的影响。

方法

进行了一项2016年至2020年的单中心回顾性比较队列研究。2018年10月，瑞典萨尔格伦斯卡大学医院实施了包括八项不同措施的手术护理包。纳入接受非重建性乳腺癌手术的患者进行分析。主要终点是术后30天内的手术部位感染。

结果

总体而言，10.4%的患者（100/958）发生了手术部位感染。实施手术护理包后，总体手术部位感染率从11.8%降至8.9%（P = 0.15）。在接受保乳手术和前哨淋巴结活检（SLNB）的亚组中，手术部位感染率下降幅度最大，从18.8%降至9.8%（P = 0.01）。在这项对患者和治疗因素进行调整的多变量分析中，手术护理包的实施导致手术部位感染风险在统计学上显著降低（OR 0.63，95%CI 0.40 - 0.99，P = 0.04）。