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伤口冲洗预防择期结直肠手术手术部位感染:一项回顾性队列研究

Wound Irrigation in the Prevention of Surgical Site Infection in Elective Colorectal Surgery: A Retrospective Cohort Study.

作者信息

Shet Sahil S, Earley Helen, Creavin Ben, Shet Aryan S, NicGabhann Cliodhna, McCullough Peter, Cooke Fiachra, Neary Peter

机构信息

Department of General and Colorectal Surgery, University Hospital Waterford, Waterford, IRL.

GKT School of Medical Education, King's College London, London, GBR.

出版信息

Cureus. 2024 Jul 16;16(7):e64662. doi: 10.7759/cureus.64662. eCollection 2024 Jul.

Abstract

Background Surgical site infection in colon surgery is associated with significant cost and increased length of hospital stay. Recently, there has been interest in the use of pulsed lavage to reduce the risk of surgical site infection in contaminated wounds. Although increasingly used and gaining popularity, its effectiveness in elective colorectal surgery has been poorly documented. This study aimed to investigate the incidence of surgical site infection within 30 days of elective colorectal surgery in patients who underwent wound irrigation with pulse lavage versus standard closure. Methodology A retrospective study was conducted at a university hospital over a two-year period between January 2020 and December 2021. All adult patients who underwent elective colorectal surgery were eligible for inclusion. Results A total of 222 patients underwent elective colorectal surgery during the study period. Operative procedures included abdominoperineal resections, left and right hemicolectomies, pelvic exenterations, small bowel or large bowel resections, as well as stoma reversals, formations, and refashioning. In total, 76 patients underwent pulse lavage while 146 did not. The total number of surgical site infections was 39 during the study period. Infection rates in the pulse lavage group were 14.47% compared to 19.18% in the standard closure group. The chi-square analysis concluded the difference in infection rates was not statistically significant (p = 0.213). Conclusions The findings demonstrated a difference in infection rates of almost 5% favouring the pulse lavage group; however, it did not reach a statistical difference. Although infection rates were in keeping with those described in the literature, further studies in the form of randomized controlled trials should be performed to determine the benefits, if any, of pulse lavage in colorectal surgery.

摘要

背景

结肠手术中的手术部位感染会带来高昂的成本,并延长住院时间。最近,人们对使用脉冲冲洗来降低污染伤口手术部位感染的风险产生了兴趣。尽管其使用越来越广泛且越来越受欢迎,但其在择期结直肠手术中的有效性鲜有文献记载。本研究旨在调查接受脉冲冲洗伤口冲洗与标准缝合的患者在择期结直肠手术后30天内手术部位感染的发生率。

方法

在一所大学医院进行了一项为期两年的回顾性研究,时间从2020年1月至2021年12月。所有接受择期结直肠手术的成年患者均符合纳入标准。

结果

在研究期间,共有222例患者接受了择期结直肠手术。手术方式包括腹会阴联合切除术、左右半结肠切除术、盆腔脏器清除术、小肠或大肠切除术,以及造口回纳术、造口形成术和造口重塑术。总共有76例患者接受了脉冲冲洗,而146例未接受。研究期间手术部位感染的总数为39例。脉冲冲洗组的感染率为14.47%,而标准缝合组为19.18%。卡方分析得出感染率的差异无统计学意义(p = 0.213)。

结论

研究结果表明,脉冲冲洗组的感染率差异近5%,有利于脉冲冲洗组;然而,未达到统计学差异。尽管感染率与文献中描述的一致,但应以随机对照试验的形式进行进一步研究,以确定脉冲冲洗在结直肠手术中的益处(如果有的话)。

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