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Objective To prepare a new-type acellular dermal matrix (ADM) and research on its relevant performance,which would provide theoretical evidence for clinical application.Methods Skin of Bama suckling pig was taken as resource of skin,and technologies of physics,chemistry and biology were selected to prepare new-type ADM.To detect the external structure,physical and chemical property as well as biological property of the prepared new-type ADM,hematoxylin-eosin (HE) staining observation,scanning electron microscope observation,amino acid analysis,material porosity and hydrophilicity test,tensile strength and in vitro degradation experiment,cytotoxicity test,and animal experiment have been conducted.Results New-type ADM cells have been thoroughly removed and dermal matrix remains intact with collagen content of 95.55％,connective three-dimensional pore structure,(85.03 ± O.99) ％ of porosity,(24.56 ± 0.57) ° of contact angle implying new-type ADM was hydrophilic substance,(5.48 ± 0.44) Pa of tensile strength implying its moderate level of pulling force,in vitro degradation period reduced to (28.7 ± O.76) h,and ＞75％ relative growth rate (RGR).Cells grew and proliferated on new-type ADM and could be replaced by original tissue after degradation.Conclusions New-type ADM have overcome disadvantages of traditional preparation method in sabotaging dermal matrix structure and incompletely removing cells from matrix,which is qualified with higher level of collagen content and porosity.With improved biological property,greatly reduced inflammation immunoreactions,and accelerated degradation rate,new-type ADM is of higher level of clinical application value.
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Objective To investigate the change in distribution and antimicrobial resistance of Acinetobacter baumannii (AB) in an intensive care unit(ICU),and provide basis for rational use of antimicrobial agents in the clinical practice.Methods Using retrospective investigation study,data about pathogenic bacteria isolated from patients who were hospitalized in ICU in 2010-2014 were collected,distribution and antimicrobial resistance of AB were statistically analyzed.Results A total of 3 807 bacterial strains were isolated from ICU patients in 2010-2014,488 (12.82％) of which were AB,isolation rate increased from 6.94％ in 2010 to 17.33％ in 2014 (x2 =45.58,P＜0.01).AB was mainly isolated from sputum,accounting for 72.13％,followed by wound secretion,blood,catheter,urine and so on;AB had the lowest resistance rate to amikacin(＜30 ％),resistance rates to imipenem and meropenem increased significantly year by year (value of trend x2 test were 42.99 and 53.91 respectively,both P＜0.001);resistance rates of AB to other antimicrobial agents were all＞50％.Conclusion Detection rate and antimicrobial resistance rate of AB increased year by year,clinical surveillance on bacterial resistance should be paid more attention,patients should be isolated by effective measures,so as to control and prevent the prevalence of AB in ICU.
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Objective To understand characteristics and research status of literatures related to surgical site infec-tion(SSI)in China.Methods Literatures about SSI published between January 2000 and March 2016 were retrieved from China National Knowledge Infrastructure(CNKI),VIP database,Vanfang Database,and China Biology Medi-cine(CBM)database. Bibliometric method was adopted to analyze external and internal characteristics of literatures. Results A total of 1036 articles in Chinese were included,40(3.86% ),189(18.24% ),and 807(77.90% )were published in 2000-2005,2006-2010,and the first quarter of 2011-2016 respectively. Articles were mainly pub-lishedinChineseJournalofNosocomiology(n= 226,21.81% ),ChineseJournalofInfectionControl(n= 53, 5.12% ),andChineseJournalofDisinfection(n= 27,2.61% ). The research fields included risk factors(n= 277, 26.74% ),infection rates (n= 261,25.19% ),antimicrobial application (n= 208,20.08% ),and pathogens (n=153,14.77% );the infection rates were higher in general surgery and neurosurgery,the main pathogens were Esch-erichiacoli,Staphylococcusaureus,and Pseudomonasaeruginosa,risk factors mainly included the types of incision, duration of surgery,diabetes,age,and body mass index.Conclusion In recent years,articles about SSI research in-creases significantly,research in etiology and epidemiology has gained substantial achievement,but in the interven-tion and economics is still weak,suggesting that SSI research in economics,risk management,and behavioral aspects should be strengthened.
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Objective To understand the current situation and existing problems in the training of healthcare-asso-ciated infection(HAI)management,and provide scientific basis for strengthening the management of HAI preven-tion and control system.Methods A questionnaire survey was adopted to investigate situation of training on HAI in 15 provincial-level HAI training agencies in China during the past 30 years,and basic condition of training on HAI management in recent 5 years.Results Among 15 provincial-level training agencies,66.67%(n=10)were respon-sible by HAI management quality control centers,80.00% have already conducted training in each city,53.33%carried out training for 10 to 20 times,33.34% performed training for ≤2 times per year.Of 33 728 trainees in 2011-2015,41.30% were 41-50 years old,61.82% were nursing staff,50.56% had bachelor degree,43.96%were with the intermediate professional title.Most trainers were HAI prevention and control experts in their respec-tive province,accounting for 68.07%,the curriculums were mainly designed on professional course,and only 26.78% were involved in management.Conclusion Professional structure of HAI management personnel is not reasonable,faculty is imbalance,knowledge update is lacking,and HAI training and education system need to be improved further.
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Objective To investigate the incidence of surgical site infection (SSI)in patients undergoing orthopedic surgery,analyze the risk factors,and provide basis for the prevention and control of SSI.Methods All hospitalized orthopedic patients undergoing surgery in a hospital from January 2010 to December 2014 were retrospectively sur-veyed,questionnaires were designed,patients’medical records were reviewed,incidence of SSI was analyzed,risk factors for SSI were analyzed with univariate and logistic regression methods.Results A total of 14 300 orthopedic patients undergoing surgery were investigated,576 (4.03%)patients had SSI,predominantly were superficial inci-sion infection (n=429,74.48%),615 strains of pathogenic bacteria were isolated from 576 patients,mainly were Staphylococcus aureus (n=137,22.28%),Escherichia coli (n=84,13.66%),and Enterobacter cloacae (n=73, 11 .87%).The incidence of SSI decreased year by year in patients undergoing orthopedics surgery(χ2 =24.706,P <0.001);the incidence of SSI in patients with amputation was the highest (22.67%),followed by patients with de-bridement (7.16%);multivariate logistic regression analysis indicated that long duration of operation,long length of hospital stay,underlying diseases,use of implants,contaminated incision,more intraoperative blood loss,irra-tional perioperative use of antimicrobial agents,and without using negative pressure drainage were independent risk factors for SSI in patients undergoing orthopedic surgery.Conclusion The incidence of SSI is high in orthopedic pa-tients undergoing surgery,effective preventive measures should be actively taken according to the related risk factors of SSI,so as to reduce the occurrence of SSI.
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In view of risk characteristics of surgical site infection,the risk factors of the infection were graded and classified while the risk indicators system and risk assessment matrix for surgical site infection were built,based on literature analysis,integrated use of documents analysis,Delphi method and risk quantification matrix.The study indicated that surgical skills of the surgeon and surgical time length are the most important risk factors,followed by insufficient maintenance of the operating room environment and poor baseline assessment of the patient.Risk control of surgical site infection needs to focus on these key factors,optimize utilization of resources and improve the prevention and control ability of surgical site infection.
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Objective To evaluated the impact of obesity on surgical site infection (SSI)following colorectal cancer surgery.Methods A total of 215 patients undergoing radical surgery for colorectal cancer in a hospital be-tween January 2008 and December 2013 were investigated retrospectively,100 patients were with body mass index (BMI)≥25 kg/m2 (obesity group)and 115 patients with BMI60 mL,58(58.00%)patients’duration of surgery was >220 min ,20 (20.00%)of whom developed postoperative SSI;in normal weight group,30(26.09%)patients had intra-operative blood loss of >60 mL,20(17.39%)patients’duration of surgery was >220 min,8(6.96%)of whom developed postoperative SSI.Intra-operative blood loss and incidence of SSI in obesity group were both signif-icantly higher than normal weight group,duration of surgery and postoperative length of hospital stay were both longer than normal weight group(both P <0.05).Conclusion Incidence of SSI in colorectal cancer patients is high. Obesity,long duration of surgery,and more bleeding are high risk factors for SSI in colorectal cancer patients.