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OBJECTIVE:To systematically evaluate therapeutic efficacy of local application of gentamicin collagen sponge in the prevention of surgical incision infection,and to provide evidenced-reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CJFD,VIP and Wanfang databases,randomized controlled trials (RCTs) about lo-cal application of gentamicin collagen sponge(trial group)vs. routine surgery disposal(control group)in the prevention of surgical incision infection were collected. After data extraction and quality evaluation with modified Jadad scale,Meta-analysis was per-formed by using Rev Man 5.3 statistical software. RESULTS:A total of 16 literatures were included,involving 7752 patients. The results of Meta-analysis showed that the incidence of surgical incision infection in trial group was significantly lower than control group,with statistical significance [OR=0.71,95%CI(0.61,0.84),P100 mg) was significantly lower than control group;there was no statistical significance between gentamicin low-dose group (≤100 mg) and control group [OR=0.96,95%CI(0.72,1.28),P=0.77]. CONCLUSIONS:Local application of gentamicin collagen sponge may have certain effect on the prevention of surgical infection. Different types of surgery,observation time and dose have different prevention effects. It should be used carefully according to clinical practice.
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Objective To study the infection prevention effect of a new type of bulb syringe during posterior lumbar surgery, which can execute pulse irrigation continuously. Methods Totally 30 patients undergoing multi-level posterior lumbar interbody fusion surgery from June to December 2016 were divided into an experiment group and a control group. The experiment group applied the bulb syringe, and the control group used tipping irrigation. The two groups were compared on intraoperative irrigation time, the development trend of C-reactive protein (CRP) 1, 3 and 5 days after surgery, incidence of postoperative pyrexia, wound healing and suture-removal time. Results The experimental group had the intraoperative irrigation time being (2.13±0.15)min, which was significantly shorter than that [(5.59±1.24)min] in the control group. In the experimental group, the CRP measurement values 1, 3 and 5 days after surgery were 46, 19 and 5 mg/L respectively and showed adeclining trend;in the control group, the CRP measurement values 1, 3 and 5 days after surgery were 49, 52 and 61 mg/L respectively and showed an increasing trend. There were 3 cases of incision exudation in the control group while none in the experimental group. The experimental group had the suture-removal time being 11.57 d, which was statistically less than that (14.29 d) in the control group. The body temperature 3 and 5 days after surgery was (37.1±2.26) and (37.0±0.12)℃respectively in the experimental group while (38.2 ±3.34) and (37.5 ±0.25)℃in the control group, and there were obvious differences between the two groups (P<0.05). There were no infected incision occurred in the two groups. Conclusion The bulb syringe gains advantages over the traditional irrigation in easy operation, short time and incidence of infected incision, and thus is worthy promoting clinically.
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Objective To investigate the effect of low dose lipopolysaccharide ( LPS ) preconditioning on prevention of incision infection by drug-resistant bacteria.Methods Methicillin-resistant Staphylococcus aureus ( MRSA) suspension with concentration of 1.8 ×109 CFU/mL was prepared.Sixty BALB/c mice were randomly divided into five groups (12 in each group, half male and half female).A medical longitudinal incision of the right thigh was made in mice in group 1-4, and 1, 0.5, 0.25 and 0 mL bacteria suspension was dropped on the surface of the incision and the incision was observed 4d after the model established.Group 5 was the blank control.Then 112 BALB/c mice were randomly divided into 7 groups ( each group had sixteen mice, half male and half female ): group A ( preconditioned with LPS 0.25 mg· kg-1· time-1), group B ( preconditioned with LPS 0.5 mg · kg-1 · time-1 ), group C (preconditioned with LPS 1 mg· kg-1 · time-1 ), group D (preconditioned with LPS 1.5 mg· kg-1 · time-1 ) , group E ( preconditioned with sterile normal saline) , group F ( incision infected) , and group G ( blank control) .LPS was given by intraperitoneal injection 48 h and 24 h before the establishing of the infection model.Body temperature was monitored every day after the model established, blood routine examination was performed on d3 and d7, and serum cytokines was detected on d7.All the mice were sacrificed on d7, and soft tissues around the incision were taken for hematoxylin-eosin staining.Repeated measures ANOVA and univariate ANOVA were performed for data analysis. Results Redness and suppuration were observed in 6 mice infected with 0.5 mL bacteria suspension, respectively, then 0.5 mL bacteria suspension was used for LPS preconditioning experiments.With LPS preconditioning, the body temperatures of mice in group B were with relatively minor changes, and the rises of white blood cells and lymphocytes on d3 and d7 were relatively modest.Granulocytes in group B returned to the normal level on d7.Besides, the rises of interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-αin group B were also less, while IL-10 was increased greatly.Suppuration was observed in 4 mice in group B ( 4/16, 25.00%), and the rate was lower than group D, E and F (χ2 =7.988, 19.940 and 19.940,P<0.01). Conclusion LPS (0.5 mg· kg-1 · time-1 ) preconditioning can reduce the severity of incision infection caused by MRSA in mice.
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Objective To investigate the application value of continuous irrigation and vacuum suction by subcutaneous drainage tube for prevention of abdominal type Ⅳ incision infection.Methods A prospective,single-blind, randomized, controlled study was conducted based on the clinical data of 123 patients with abdominal type Ⅳ incision infection who were admitted to the First People's Hospital of Foshan between January 2008 and July 2014.Patients were divided into the experimental group and the control group based on the random number table and received open surgery.Patients in the experimental group were placed subcutaneous drainage tube with postoperative continuous irrigation and vacuum suction, while patients in the control group adopted the method of traditional abdominal closure without subcutaneous drainage tube.The levels of preoperative hemoglobin (Hb) and albumin (Alb), severity grading according to the American Society of Anesthetheologists (ASA), levels of Hb and Alb at postoperative day 1, 3, 7 were recorded and postoperative incision infection and bacteria culture were observed.Patients received bi-weekly regular return visit by outpatient evamination after discharged up to 3 months after suture removal.Measurement data with normal distribution were presented as x-± s and comparison between groups was analyzed by t test.Measurement data with skew distribution were presented as M (Qn) and comparison between groups were analyzed by rank sum test.Repeated measures data were analyzed by the repeated measures ANOVA.Count data were analyzed by the chi-square test.Results One hundred and twenty-three patients were screened for eligibility, and 65 were allocated into the experimental group and 58 into the control group.The levels of Hb and Alb at postoperative day 1, 3, 7 were (111 ± 15) g/L, (107 ± 18) g/L, (108 ± 13) g/L and 30 g/L (26 g/L,32 g/L), 31 g/L(28 g/L,33 g/L), 35 g/L(32 g/L,37 g/L) in the experimental group and (112 ± 13)g/L, (106 ±16)g/L, (106 ± 12)g/L and 30 g/L(25 g/L,32 g/L), 32 g/L(29 g/L,33 g/L), 37 g/L (32 g/L,38 g/L) in the control group, with no significant difference in the changing trends of the above indexes between the 2 groups (F =0.124, 0.007, P ＞ 0.05).There were 4 patients with incision infection in the experimental group and 12 patients in the control group, showing a significant difference (x2=2.723, P ＜ 0.05).The infections occurred at postoperative 4-6 days confined to subcutaneous tissues and unreached to muscular and below layers, and then were cured by incision open drainage without recurrence.Patients without incision infection were removed the stitches at postoperative 7-9 days.Incision bacteria cultures showed that Escherichia coli was detected in 8 cases (including 1 complicated with Enterococcus faecalis and 1 complicated with Klebsiella pneumonia and Pseudomonas aeruginosa), Pseudomonas aeruginosa in 1 case, Klebsiella pneumonia in 2 cases, Acinetobacter baumanii in 1 case, Enterobacter cloacae in 1 case and no bacteria in 3 cases.All the patients were followed up for 3 months after incision healing and survived well without recurrence and complications such as incision split and incision fistula.Conclusion Continuous irrigation and vacuum suction by subcutaneous drainage tube can be operated easily and effectively reduce the postoperative infection rate in abdominal type Ⅳ incision.
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Objective To investigate the risk factors of cesarean section operation incision infection ,so as to provide refer‐ence for preventing and controlling cesarean section operation incision infection effectively .Methods A total of 29 cases were se‐lected who hospitalized in our hospital during December 2011 and December 2012 and whose incision of cesarean operation was in‐fected as the observation group .They were retrospectively analyzed .Then another 29 cases were chosen whose incision of cesarean operation was not infected as the control group .The clinical data in two groups were compared and the risk of infected incision were investigated .Results The incision infection occurred in 29 of 589 cases undergoing cesarean section with the infection rate 4 .9% . Univariate analysis showed that ,the maternal BMI in observation group was (25 .9 ± 1 .1)kg /m2 ,uterine scar for 6 cases ,emergency operation for 18 cases ,operation time was(1 .2 ± 0 .6) h ,the hospitalization time was (7 .1 ± 2 .3) d ,6 cases with underlying disease , premature rupture of membranes for 12 cases ,the vagina and anus diagnosis number was(3 .3 ± 0 .6) times ,the comparison with the control group ,the difference was statistically significant (P< 0 .05) .Multivariate Logistic regression analysis showed ,BMI (OR =2 .802) ,operation time (OR = 5 .813) ,with basic diseases (OR = 6 .182) ,premature rupture of membranes (OR = 11 .219) were risk factors for cesarean section operation incision infection .Conclusion There are many factors that can influence the surgical incision infections .It is necessary for the high‐risk population to take effective measures to prevent surgical incision infections .
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Objective To investigate the high risk factors causing abdominal operation incision infection in department of general surgery as well as explore the treatment measures in order to reduce the rate of postoperative incision infection.Methods Retrospective analysis was conducted.Two thousand one hundred and eighteen patients underwent abdominal operation in the Tangshan Branch of Hebei Corps Hospital of China People's Armed Police from Jan.2006 to Mar.2013 were selected as our subjects.Of them,there were 89 cases infected incision after operation and served as the observation group.Selected 80 cases patients without incision infection in the same period served as control group.The difference between two groups related factors were compared.Results In observation group,cases with aged over 60 years old,body mass index (BMI) over 25 kg/m2,complicated with metabolism disease,Ⅲ incision,operation period over 2 h,antibiotics application before operation,malignant tumor and use of electric knife were 18 (20.22％),19 (21.35％),12 (13.48％),17 (19.10％),28 (31.46％),13 (14.61％),11 (12.36％) and 28 (31.46％),respectively;significant different from those in control group (5 (6.25％),4 (5.00％),3 (3.75％),4 (5.00),11 (12.75％),3 (3.75％),2 (2.50％),11 (13.75％);P＜0.05).Conclusion There are a lot of factors causing abdominal incision infection in department of general surgery.The indices of high age,high BMI,with basic diseases,incision type Ⅲ,operation period over 2 h,without antibiotics application,with malignant tumor,use of electric knife are risk factors.
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Objective To investigate the risk factors of incision infection in elderly patients of general surgery.Methods The clinical data of 306 elderly patients of general surgery were analyzed retrospectively.The risk factors of incision infection were analyzed.Results The rate of incision infection was 10.5％ (32/306).The rate of incision infection in chronic disease patients was higher than that in non-chronic disease patients [12.9％(27/210) vs.5.2％(5/96)],the rate of incision infection in summer was significantly higher than that in spring,autumn and winter[16.3％(15/92) vs.8.4％(7/83),8.5％(6/71) and 6.7％ (4/60)],the rate of incision infection in operative time longer than 120 min patients was higher than that in operative time less than 120 min patients [15.0％ (18/120) vs.7.5％ (14/186)],the rate of incision infection in emergency surgery patients was higher than that in non-emergency surgery patients [12.3％ (20/162) vs.8.3％(12/144)],there had significantly difference (P＜ 0.05).Conclusion Chronic disease,summer,operative time longer than 120 min,emergency surgery in elderly patients are the mainly risk factors of incision infection in general surgery.
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Objective To evaluate the effectiveness of incisional infusion through local anesthetics under a continuous-infusion elastomeric pump for the management of postoperative pain after laparotomy,on reducing the amount of opioids being used after surgery.Methods We performed a retrospective comparative analysis on 285 patients who had undergone laparotomies between January 2012 and September 2012.Among those patients,144 took a continuous-infusion elastomeric pump to receive local anesthetic (LA) at the incisional area for postoperative pain management while another 141 patients took ‘patient-controlled' intravenous analgesia (PCA).Data were reviewed on items as:visual analog pain scores (VAS) during both resting and active situation,mean opioid use,bowel function,condition of incision and complications etc.Results Both groups showed similar VAS scores for the first 48 hours post-operation.However,in the LA group,VAS scores appeared significantly higher within the first 72 hours (P＜0.001),with less opioid use (P＜ 0.01),less symptoms as postoperative nausea or vomiting (P＜ 0.001),with earlier recovery of bowel function (P＜0.01) etc.when compared to the PCA group.No significant difference found on the incidence rates of wound infection other than,a higher rate of incisional drainage (P＜0.001) was seen in the LA group.Conclusion Continuous infusion of local anesthetic under an elastomeric infusion pump post the laparotomy,a similar analgesic effect could be seen on those patient-controlled intravenous analgesia within the first 48 hours,it could also reduce opioid consumption and postoperative symptoms as nausea or vomiting,which all appeared to be associated with the earlier recovery of bowel function.
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Objective To investigate the means which can prevent postoperative incision infection of elderly patients with obstructive colorectal cancer. Methods Sixty-seven cases of elderly patients with obstructive colorectal cancer adopting surgical treatment were divided into two groups, including experimental group with 37 cases and control group with 30 cases. Put self-made negative pressure drainage tube with side-hole into subcutaneous interspace of abdominal incision of experimental group alter operation, kept continuous negative pressure drainage 7-10 d and pull out the self-made subcutaneous negative pressure drainage tubes till drainage volume decreased obviously. The abdominal wall incisions of the control group were given conventional suture. Results Incision infection occurred in only one case (2.7%) and no incision dehiscence occurred in the experimental group, and incision healing time was (9.36 ± 2.18) d. Incision infection occurred in 7 cases (23.3%) in the control group, of which there were 3 cases (10.0%) of wound dehiscence, incision healing time was (12.25 ±4.06) d. Incision infection rate of the two groups had significant difference (χ2= 6.706,P < 0.05), incision dehiscence rate of the two groups had no significant difference (P 0.05), incision healing time of the two groups had significant difference (t = 6.676, P < 0.05). Conclusion Using the self-made subcutaneous negative pressure drainage tube and keeping it continuous negative pressure drainage after operation can be effective in preventing incision infection of elderly patients with obstructive colorectal cancer, and promote wound healing.
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4 h,and for class Ⅰ and class Ⅱ operation.
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OBJECTIVE To discuss the related factors and the prevention of incision infection in general surgery.METHODS The data of 1830 general surgical patients were analyzed retrospectivly.The observation group consisted of patients with surgical incision infection and the control group was of Non-infected patients,and the factors that might cause incision infection were analyzed by single-factor and logistic regression.RESULTS From 1830 cases,57 cases were with incision infection.Its prevalence was 3.11%.Their were 10 factors related to the incision infection by single-factor analysis,and after logistic regression analysis,we knew that were older age,higher BMI,long surgery time,emergent surgery,and combined with underlying diseases were the related factors causing incision infection.CONCLUSIONS General surgery incision infection rate is higher deu to a variety of factors.We should target at the related risk factors to prevent and control the incision infection.
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OBJECTIVE To discuss the effect of preventive medication for preventing incision infection before cesarean.METHODS Patients with cesarean section accepted parturients were divided in 2 groups randomly: group A(medicine before operation) and group B(no medicine before operation),and infection rate were observed after operation.RESULTS The incision infection rate of group A was 3.8%,and that of group B was 9.3%(?2=6.00,P
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Objective To clarify great benefit to prevention of wound infection as well as reduction of economic expenditures by a new method of connecting latex gloves and cigarettes in peritoneal drainage. Methods We randomly selected 121 cases of patients with peritoneal pyogenic infection, divided them into the latex gloves group (64 eases)and the common dressing group (57 cases). The incision infection rate and eco-nomic cost in two groups were comparately studied. Results The latex gloves group's incision infection rate was 10.94% (7 / 64), the common dressing was 31.58% (18/57). Each patient of the latex gloves group spent less cost about 15.70 yuan,changed dressing 5.3 times less than the common dressing group. Conclusions Connecting latex gloves and cigarettes in peritoneal drainage is a new method of reducing economic expandi-tures and the chances of incision infection. Clinical application of this method should be fully prospected.
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OBJECTIVE To study and find reasonable methods of nursing care of incision through analyzing the risk factors in liver transplant patients.METHODS A total of 416 liver transplantation operations in our hospital from Sep 2004 to May 2006 were evaluated.The risk factors that resulted in the incision infection were considered.RESULTS The incision infection rate was decreased from 13.9% to 4.3% after improvement.CONCLUSIONS Nursing care is of great significance in preventing the incision infection in liver transplant patients.
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OBJECTIVE To analyze the high incision infection rate in abdominal operation in order to take effective preventive measures.METHODS Totally 2302 cases of abdominal operation in general surgery were investigated retrospectively from Jan 2005 to May 2007.The diagnosis standard was based on the Diagnosis Standard of Hospital Infection(Draft) published by Ministry of Health of the People′s Republic of China in Jan 2001.RESULTS From them 113 cases suffered incision infection.The infection rate was 4.85%,accounted for 81.54% of all surgical operation incision infections.The pathogenic bacteria in the samples taken during the operation were the same as those in the secretion of postoperative incision in terms of species and source.CONCLUSIONS The key points of prevention of incision infection are sterile operation,flushing of abdominal cavity and enhanced detection of environment hygiene in operating room.The infection rate could be lowered through observation and nursing care of postoperative incision and proper use of antibiotics.
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60 years of age) groups(10.4%),and in summer season(8.3%),when existing antibiotic-resistant pathogenic germs(90%),respectively. CONCLUSIONS The surgical site infection after abdomen operations is closely related to factors such as incision site,incision type;malignant or benign diseases;age,sex,and antibiotics-resistant pathogenic germs,etc.Effective measures should be taken accordingly to reduce the infection.
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OBJECTIVE To investigate the risk factors of infection after incisional wound in colon cancer patients for better prevention and treatment. METHODS To retrospectively analyze the colon cancer patients in whom the incision infection happened from Jan 2002 to Apr 2008. RESULTS The incidence of postoperative wound infections of the patients was 2.7%. In univariate analysis,the difference whether infections were happened in patients with diabetes was significant(P
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OBJECTIVE To detect the effect of AcasinTM dressing on surgical incision healing.METHODS Eighty cases with types Ⅰand Ⅱsurgical incision operation at outpatient clinic were divided into study group and control group.AcasinTM dressing was applied to study group while common aseptic dressing was applied to control group.The bacterial test results and the healing condition of the incision were observed.RESULTS The bacterial tests were negative in study group,the average healing time was 7.32?1.74 days,the healed rate of stage Ⅰ was 100.00%.The bacterial tests were positive in 10 cases of control group,10 cases had redness in incision,5 cases with drainage leakage,the average healing time was 10.12?2.24 days,The healed rate of stage Ⅰ was 90.00%.CONCLUSIONS AcasinTM dressing can eridicate pathogenic organism in surgical incision and suture,It can effectively prevent incision infection,and promote stage Ⅰincision healing.It is worth spread in clinic.
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OBJECTIVE To summarize the infection cases and the factors causing site infection after operations,and investigate the measures to prevent and reduce exogenous incision infection.METHODS Discharged patients from Jan 1st,2003 to May 31st,2006 in our hospital were investigated for retrospective analysis on incision infection cases.RESULTS Totally 111 incision infection cases were reported from 54 286 cases.The nosocomial infection rate in this cohort was 0.21%(111/54 286),which was 33.44% of total surgical incision infection cases.CONCLUSIONS Incision infection is one of the most commonly encountered concomitant symptoms,it is as well the bottleneck for our hospital to reduce average stay length of surgical patients and patients′ hospitalization expenses,and to speed up turnover of beds.Incision infection rate is also an important criterion to evaluate the management quality and medical technology quality within and among hospitals.Effective measures should be taken to decrease incision infection rate and to resolve the problem that is difficult to hospitalize and expensive to treat.