Department of Neurosurgery, Huaihe Hospital of Henan University, Kaifeng, China.
Department of Pediatrics, Huaihe Hospital of Henan University, Kaifeng, Henan, China.
Int Wound J. 2024 Feb;21(2):e14699. doi: 10.1111/iwj.14699.
To systematically evaluate the risk factors for wound infection at the surgical site after neurosurgical craniotomy by meta-analysis, and to provide an evidence-based basis for preventing the occurrence of wound infection. A computerised search of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure and Wanfang database was conducted for relevant studies on risk factors for surgical site wound infection after neurosurgical craniotomy published from the database inception to November 2023. Two researchers independently screened the literature, extracted the data and performed quality assessment in strict accordance with the inclusion and exclusion criteria. STATA 17.0 software was applied for data analysis. Overall, 18 papers with 17 608 craniotomy patients were included, of which 905 patients developed wound infections. The analysis showed that underlying diseases [OR = 2.50, 95% CI (1.68, 3.72), p < 0.001] and emergency surgery [OR = 2.47, 95% CI (1.80, 3.38), p < 0.001] were the risk factors for developing wound infections after craniotomy, age < 60 years [OR = 0.72, 95% CI (0.52, 0.98), p = 0.039] was a protective factor for wound infections; whereas sex [OR = 1.11, 95% CI (0.98, 1.27), p = 0.112] and the antimicrobial use [OR = 1.30, 95% CI (0.81 2.09), p = 0.276] were not associated with the presence or absence of wound infection after craniotomy. Underlying disease and emergency surgery are risk factors for developing wound infections after craniotomy, whereas age < 60 years is a protective factor. Clinicians can reduce the occurrence of postoperative wound infections by communicating with patients in advance about the possibility of postoperative wound infections based on these factors, and by doing a good job of preventing postoperative wound infections.
为了通过荟萃分析系统评估神经外科颅骨切开术后手术部位感染的危险因素，为预防手术部位感染的发生提供循证医学依据。计算机检索 PubMed、EMBASE、Cochrane 图书馆、中国知网和万方数据库，检索建库至 2023 年 11 月关于神经外科颅骨切开术后手术部位感染危险因素的相关研究。按照纳入和排除标准，由 2 位研究者独立筛选文献、提取资料并进行质量评价。采用 STATA 17.0 软件进行数据分析。共纳入 18 篇文献，包含 17 608 例颅骨切开术患者，其中 905 例发生切口感染。分析结果显示，基础疾病（OR=2.50，95%CI（1.68，3.72），p<0.001）和急诊手术（OR=2.47，95%CI（1.80，3.38），p<0.001）是颅骨切开术后发生切口感染的危险因素，年龄<60 岁（OR=0.72，95%CI（0.52，0.98），p=0.039）是切口感染的保护因素；而性别（OR=1.11，95%CI（0.98，1.27），p=0.112）和抗菌药物的使用（OR=1.30，95%CI（0.81，2.09），p=0.276）与颅骨切开术后是否发生切口感染无关。基础疾病和急诊手术是颅骨切开术后发生切口感染的危险因素，而年龄<60 岁是保护因素。临床医生可以根据这些因素提前与患者沟通术后切口感染的可能性，并做好术后切口感染的预防工作，以降低术后切口感染的发生。
