Scheer Vendela M, Scheer Johan H, Kalén Anders, Serrander Lena
Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Department of Orthopedics, Department of Biomedical and Clinical Sciences, Linkoping University Faculty of Medicine, Linköping, Sweden.
J Infect Prev. 2024 Nov;25(6):242-246. doi: 10.1177/17571774241261923. Epub 2024 Jun 15.
The modern wound dressing is produced to absorb fluid and protect against external contamination. The choice of which wound dressing to apply after surgery is usually based on local tradition. There are various impervious dressings on the market. Even if the wound is sterile before application, there will be subsequent recolonisation of skin microbiota. Previous studies suggest that a high bacterial load on the skin hampers wound healing and might be a risk for SSI.
The aim was to compare bacterial recolonisation on the shoulder under three different wound dressings, 48 h after sterile preparation of the skin as in preparation for surgery.
In 25 healthy volunteers, a standard pre-surgical skin disinfection for a deltopectoral incision was made on the left shoulder with 0.5% chlorhexidine solution in 70% ethanol. Three different wound dressings were then placed on the shoulder, and 48 h later the skin beneath each dressing was swabbed, subsequently cultured and bacterial density analysed using viable count.
The bacterial recolonisation under air-dry (gauze) dressing was significantly lower ( = .0001) compared to semipermeable and occlusive wound dressings.
Choosing a less permeable wound dressing may lead to an increased bacterial load on the skin during the first 48 h after surgery.
现代伤口敷料旨在吸收液体并防止外部污染。术后使用何种伤口敷料通常基于当地传统。市场上有各种不透水敷料。即使在使用前伤口是无菌的，皮肤微生物群随后也会重新定殖。先前的研究表明，皮肤上的高细菌载量会阻碍伤口愈合，并且可能是手术部位感染的一个风险因素。
目的是比较在皮肤进行无菌准备（如同手术准备一样）后48小时，三种不同伤口敷料覆盖下肩部的细菌重新定殖情况。
在25名健康志愿者中，用含0.5%氯己定的70%乙醇溶液对左肩进行标准的胸大肌三角肌切口术前皮肤消毒。然后在肩部放置三种不同的伤口敷料，48小时后对每个敷料下方的皮肤进行擦拭，随后进行培养，并使用活菌计数分析细菌密度。
与半透性和封闭性伤口敷料相比，风干（纱布）敷料下的细菌重新定殖显著更低（P = .0001）。
选择渗透性较低的伤口敷料可能会导致术后头48小时皮肤细菌载量增加。
