Bröte L, Gillquist J, Tärnvik A
Acta Chir Scand. 1976;142(2):99-106.
Rates of wound infection have been studied in a clinic performing to an equal degree both clean surgery and potentially contaminated surgery. Included in the study were 2827 patients with 213 (7.5%) postoperative wound infections. The postoperative mortality was 2.1%. Primary illness and cardiovascular complications were the main causes of postoperative death, while infectious complications (pneumonia, peritonitis and wound infection) were associated with or caused 1/3 of all postoperative deaths. Positive cultures from the wound before closure and from the wound dressings, immediately after operation, were followed by an increased risk of wound infection compared to negative cultures. Rates of wound infection were significantly higher in potentially contaminated operations compared to clean operations. Gram negative bacteria dominated in isolates from infected wounds after the former type of surgery, while S. aureus was the most common bacteria in wound infections after clean surgery. The time interval between operation and the discovery of wound infection was in the mean 10 days for staphylococci, and 9 days for Gram negative bacteria. The average time of hospitalization for patients contracting postoperative wound infections was 9 days longer than that for non-infected patients, which means that 3.4% of all nursing days were lost owing to excess hospitalization of infected patients.
在一家同时进行清洁手术和可能污染手术的诊所中，对伤口感染率进行了研究。该研究纳入了2827例患者，其中213例（7.5%）发生术后伤口感染。术后死亡率为2.1%。原发性疾病和心血管并发症是术后死亡的主要原因，而感染性并发症（肺炎、腹膜炎和伤口感染）与三分之一的术后死亡相关或导致了这些死亡。与阴性培养结果相比，伤口闭合前和术后立即从伤口敷料中获得的阳性培养结果会增加伤口感染的风险。与清洁手术相比，可能污染手术的伤口感染率显著更高。在前一种手术类型后，感染伤口分离出的菌株中革兰氏阴性菌占主导，而在清洁手术后的伤口感染中，金黄色葡萄球菌是最常见的细菌。葡萄球菌感染伤口的手术与发现伤口感染之间的平均时间间隔为10天，革兰氏阴性菌感染伤口的平均时间间隔为9天。发生术后伤口感染的患者的平均住院时间比未感染患者长9天，这意味着所有护理天数中有3.4%因感染患者的过度住院而损失。
