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脑血管手术中手术部位感染的发生率:一项单中心队列研究。

Incidence of surgical site infections in cerebrovascular surgery: a single-center cohort study.

作者信息

Colombo Elisa, Grob Alexandra, Sarnthein Johannes, Fierstra Jorn, Esposito Giuseppe, Regli Luca, Germans Menno

机构信息

Department of Neurosurgery and Clinical Neuroscience Center, University Hospital of Zurich, University of Zurich, Switzerland.

出版信息

Brain Spine. 2025 Aug 6;5:104389. doi: 10.1016/j.bas.2025.104389. eCollection 2025.

Abstract

INTRODUCTION

Surgical site infections (SSI) constitute a source of morbidity in neurosurgical patients. Few reports address incidence of SSIs in patients undergoing craniotomy for neurovascular diseases.

RESEARCH QUESTION

This study aims to determine incidence and characteristics of SSI with interval to diagnosis, severity, and type of pathogen after intracranial neurovascular surgery.

MATERIALS AND METHODS

Data from consecutive patients undergoing intracranial neurovascular surgery between January 2013 and 2022 were retrospectively analyzed in our tertiary referral center. Demographic data, risk factors, treatment and hospital stay were collected. Impact of SSI were classified according to Clavien Dindo Grade (CDG). Parameters studied included the time from index to revision surgery, microorganisms involved, and underlying pathology for the index surgery.

RESULTS

Among 1065 neurovascular surgeries, SSI occurred in 34 cases (2.1 %, n = 19 males). Median patient's age was 53 years (interquartile range, IQR 45-60). The median time from the index procedure to surgical wound revision was 27.5 days (IQR 19-44). The median length of hospital stay after revision surgery was 7 days (IQR 4-15). The predominant pathogen was Staphylococcus epidermidis (11, 32 %), followed by Staphylococcus aureus (8, 22 %). In 32 cases (89 %) wound revision was performed under general anesthesia.

DISCUSSION AND CONCLUSIONS

The overall incidence of SSI in our center was 2.1 % with a mean time to wound revision of 29 days. These numbers can be used as a benchmark and reference for strategies that implement a reduction of postoperative infections in neurovascular surgery.

摘要

引言

手术部位感染(SSI)是神经外科患者发病的一个原因。很少有报告涉及因神经血管疾病接受开颅手术患者的SSI发生率。

研究问题

本研究旨在确定颅内神经血管手术后SSI的发生率、特征,以及诊断间隔、严重程度和病原体类型。

材料与方法

在我们的三级转诊中心,对2013年1月至2022年期间连续接受颅内神经血管手术的患者数据进行回顾性分析。收集人口统计学数据、危险因素、治疗情况和住院时间。根据Clavien Dindo分级(CDG)对SSI的影响进行分类。研究参数包括从初次手术到翻修手术的时间、涉及的微生物以及初次手术的基础病理情况。

结果

在1065例神经血管手术中,34例发生了SSI(2.1%,男性19例)。患者中位年龄为53岁(四分位间距,IQR 45 - 60)。从初次手术到手术伤口翻修的中位时间为27.5天(IQR 19 - 44)。翻修手术后的中位住院时间为7天(IQR 4 - 15)。主要病原体是表皮葡萄球菌(11例,32%),其次是金黄色葡萄球菌(8例,22%)。32例(89%)伤口翻修手术在全身麻醉下进行。

讨论与结论

我们中心SSI的总体发生率为2.1%,伤口翻修的平均时间为29天。这些数据可作为神经血管手术中实施减少术后感染策略的基准和参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dba0/12396278/9362bba657a7/gr1.jpg

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