Kaufner H K, Winter G, Friedrich B
Zentralbl Chir. 1978;103(24):1623-31.
In a consecutive series of 150 fractures treated surgically 16 wound infections were observed. Evaluating the intraoperative wound swabs, type and localisation of the fractures, duration of operation and tourniquet time it was tried retrospectively to find a relationship to these posttraumatic wound infections. The highest rate of infection was found in fractures of the tibia. Open fractures had a higher risk than closed ones. Furthermore, a prolonged duration of operation was related to a rising risk of infection. The intraoperative wound swabs themselves did not allow any conclusion concerning the risk of postoperative infection. Postoperative wound infections appeared nearly as frequent after negative as after positive intraoperative swab. Only the species of bacterias found intraoperatively allowed a conclusion concerning subsequent wound infection so far that after an intraoperative finding of gram-negative bacterias and - surprisingly - apathogenic sporogenic bacterias postoperative wound infections were observed more frequently than after finding other bacterias. In summary, however, the routine intraoperative wound swab does not seem to be suitable as a sreening-test for early recognation of impending postoperative wound infections.
在连续接受手术治疗的150例骨折患者中，观察到16例伤口感染。通过评估术中伤口拭子、骨折类型和部位、手术时间及止血带使用时间，试图回顾性地找出与这些创伤后伤口感染的关联。发现胫骨骨折的感染率最高。开放性骨折比闭合性骨折的感染风险更高。此外，手术时间延长与感染风险增加有关。术中伤口拭子本身无法得出关于术后感染风险的任何结论。术中拭子结果为阴性和阳性的患者术后伤口感染发生率几乎相同。目前仅术中发现的细菌种类能对后续伤口感染情况作出判断，即术中发现革兰氏阴性菌以及——令人惊讶的是——无致病性产孢细菌后，术后伤口感染的发生率高于发现其他细菌后的情况。然而，总体而言，常规术中伤口拭子似乎并不适合作为早期识别术后伤口感染的筛查检测手段。
