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综合医院小儿手术伤口感染(作者译)

[Infection of pediatric operative wounds in a general hospital (author's transl)].

作者信息

Tovar J, Burdeus R, Conde J, Pérez-Trallero E

出版信息

An Esp Pediatr. 1980 Jan;13(1):33-42.

PMID:7369636
Abstract

During the two-year 1977-1978 period 37 (3.29%) out of 1,124 pediatric surgical wounds became infected in the postoperative course. Ten infections were observed among the 844 "clean" procedures (1.18%), 5/155 "clean-contaminated" (3.22%), 3/32 "contaminated" (9.37%) and 19/93 "dirty" (20.43%). These rates are quite comparable, although somewhat lower, to those found in similar studies carried out in adults. The bacteriologic studies of the contamination and the subsequent infection revealed that "clean" wounds were almost exclusively infected by "Staphilococci", while all the remaining categories (which very often implicated an opening of digestive tract lumen) became infected by multiple endogenous flora including enterobacteriae (mainly "E. coli") and anaerobic germs ("Bacteroides" and "Clostridia"). The limited use of antibiotics in this series was guided by these bacteriologic findings, a fact that can partially explain our results. There was no mortality directly related to the infection of the wound, but the risks and uncomfort incurred by the patients were not negligible and must be taken into consideration aside with the increase of the cost of hospital stay (evaluated as 35,000-100,000 ptas./patient in this series) to justify every effort to decrease incidence of this generally minor complication.

摘要

在1977年至1978年的两年期间,1124例儿科外科手术伤口中有37例(3.29%)在术后过程中发生感染。在844例“清洁”手术中有10例感染(1.18%),155例“清洁-污染”手术中有5例(3.22%),32例“污染”手术中有3例(9.37%),93例“脏污”手术中有19例(20.43%)。这些发生率与在成人中进行的类似研究中发现的发生率相当,尽管略低。对污染及随后感染的细菌学研究表明,“清洁”伤口几乎完全由“葡萄球菌”感染,而所有其余类别(这些类别常常涉及消化道腔的开放)则由多种内源性菌群感染,包括肠杆菌科细菌(主要是“大肠杆菌”)和厌氧病菌(“拟杆菌”和“梭菌”)。本系列中抗生素的有限使用是基于这些细菌学发现,这一事实可以部分解释我们的结果。没有与伤口感染直接相关的死亡,但患者所面临的风险和不适不可忽视,并且在考虑住院费用增加(本系列中评估为每位患者35000 - 100000比塞塔)的同时,必须考虑到这一点,以证明为降低这种通常较轻的并发症的发生率而付出的一切努力是合理的。

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