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骨科假体手术部位感染的监测:一种识别风险因素和改善临床实践的工具。

Surveillance of surgical site infections in orthopedic prosthetic surgery: a tool for identifying risk factors and improving clinical practice.

机构信息

Health Directorate Galliera Hospital, Genoa, Italy.

Department of Health Sciences, University of Genoa, Genoa, Italy.

出版信息

J Prev Med Hyg. 2024 Aug 31;65(2):E273-E277. doi: 10.15167/2421-4248/jpmh2024.65.2.3141. eCollection 2024 Jun.

Abstract

INTRODUCTION

Surgical site infections (SSIs) are among the most frequently encountered complications in prosthetic surgery, and are associated with increased hospitalization, costs and in-hospital mortality. There is no national system for the comprehensive monitoring of the incidence of SSIs.

METHODS

All patients undergoing orthopedic prosthetic surgery from April 1 to June 30, 2023 were enrolled. Clinical evaluation of the surgical site was conducted at 30 days, and a follow-up telephone interview was carried out by means of a specially designed questionnaire at 90 days.

RESULTS

A total of 59 patients were included. Surgery was performed on the knee in 71.19% and on the hip in 28.81%. The patients' mean BMI was 28.25 ± 2.97, and their mean ASA score was 2.67 ± 0.58. Six patients had diabetes mellitus. The incidence of SSIs was 5.08%; two infections occurred in knee prosthesis surgery and one in hip surgery. Analysis of the data revealed that diabetes was the main risk factor for the development of infection.

CONCLUSIONS

Although based on a small number of patients, these results are encouraging, especially considering that the patients had an average ASA score of more than 2 and a high BMI. However, to further reduce the risk of infection, improved hygiene measures have now been implemented in the operating room and the antibiotic prophylaxis protocol has been updated to take into account the potential for MRSA colonization.

摘要

简介

在假体手术中,手术部位感染(SSI)是最常见的并发症之一,与住院时间延长、费用增加和院内死亡率升高有关。目前,还没有全国范围内用于全面监测 SSI 发生率的系统。

方法

纳入 2023 年 4 月 1 日至 6 月 30 日期间进行骨科假体手术的所有患者。在术后 30 天对手术部位进行临床评估,并通过专门设计的问卷在术后 90 天进行随访电话访谈。

结果

共纳入 59 例患者。71.19%的手术部位为膝关节,28.81%的手术部位为髋关节。患者的平均 BMI 为 28.25 ± 2.97,平均 ASA 评分为 2.67 ± 0.58。6 例患者患有糖尿病。SSI 的发生率为 5.08%;2 例感染发生在膝关节假体手术中,1 例发生在髋关节手术中。数据分析显示,糖尿病是感染发生的主要危险因素。

结论

尽管基于少数患者的结果,但这些结果令人鼓舞,特别是考虑到患者的平均 ASA 评分超过 2 分且 BMI 较高。然而,为了进一步降低感染风险,现在已在手术室实施了改进的卫生措施,并更新了抗生素预防方案,以考虑到耐甲氧西林金黄色葡萄球菌定植的可能性。

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