Study on the preventive use of antibiotics in removal surgery for internal fixation / 药学实践杂志

Objective To investigate the preventive use of antibiotics for internal fixation as selective removal surgery during perioperative period.Methods The sex, age, routine blood examination data, preventive medications, secondary incision infection and postoperative hospital stay for the patients underwent selective removal surgery for internal fixation from July2015to June 2017were analyzed.Results The average postoperative hospitalization time for the preventive medication group (n=71) and the untreated group (n=350) were (1.80±1.24) days and (1.27±0.61) days.This difference was statistically significant (P＜0.05).Conclusion Preventive antibiotics use is not related to incision infections.It is recommended to correct the current behavior of the preventive drug use.The preventive antibiotics use in selective removal surgery for internal fixation in the Department of orthopedics needs to be reduced.

Evaluation of Interventional Effects of Special Prescription Comment Model on Prophylactic Application of Antibiotics during Perioperative Period of Clean Operation in Our Hospital / 中国药房

OBJECTIVE: To evaluate the effects of special prescription comment model intervention on prophylactic application of antibiotics during perioperative period of clean operation in our hospital. METHODS: By founding specialist group and prescription comment group, formulating unified form for evaluating prophylactic application of antibiotics during perioperative period of clean operation, establishing comment criteria referring to Guidelines for Clinical Antibiotics Use (2015 edition), Notice on Further Strengthening the Management of Clinical Antibiotics Use, drug package inserts and so on; havivg the aid of administrative intervention and quality assessment, The special prescription comment model was established. Based on stratified sampling (according to the clinical departments, kind of procedure), Each 180 medical records were collected from our hospital during Jan. -Jun. 2015 (before intervention) and Jan. -Jun. 2016 (after intervention). The unified form for perioperative period of clean operation was formulated to comment each medical record in respects of prophylactic utilization rate of antibiotics, medication indication, medication timing, drug selection, usage and dosage, medication course, drug combination, etc. RESULTS: After the following intervention measures were adopted, such as The prophylactic utilization rate of antibiotics of our hospital during perioperative period of clean operation decreased from 96. 7％ before intervention to 25. 0％ after intervention (P< 0. 05). The rates of drug use without indication, irrational medication timing before surgery, irrational drug selection, irrational usage and dosage, irrational medication course and irrational drug combination were decreased from 71. 3％, 72. 4％, 65. 5％, 23. 0％, 97. 1％, 17. 8％ before intervention to 4. 4％, 0, 8. 9％, 11. 1％, 22. 2％, 0 after intervention (P<0. 05) respectively. Before intervention, 8 categories 20 kinds of antibiotics were used prophylactically in our hospital during perioperative period of clean operation; 86 patients used 2 kinds of or more antibiotics, among which there were 31 cases of drug combination and 55 cases of drug replacement. After intervention, 3 categories 4 kinds of antibiotics were used prophylactically in our hospital during perioperative period of clean operation; there was no drug combination and drug replacement. CONCLUSIONS: Special prescription comment model can obviously improve rational use of antibiotics during perioperative period of clean operation.

Monitoring on surgical site infection and risk factors for clean wound orthopedic surgery / 中国感染控制杂志

Objective To investigate the incidence and risk factors for surgical site infection (SSI)in clean wound orthopedics surgery.Methods SSI among patients receiving clean wound orthopedic surgery from April 1 to Sep-tember 30 in 2014 were monitored,risk factors for SSI were analyzed.Results A total of 665 patients were moni-tored,14 cases(2.11 %)of SSI occurred.Univariate analysis showed that types of skin,skin preparation modes, and ASA score were risk factors for SSI in clean wound orthopedic surgery (all P <0.05 ).Multivariate logistic analysis revealed that conventional skin preparation,ASA score ≥ grade Ⅱ,and duration of operation ≥90 minutes were independent risk factors for SSI in patients receiving clean wound orthopedic surgery (OR [95%CI ],3.96 [1 .07-14.70],6.45[1 .97-21 .11],and 4.08[1 .35 -12.30]respectively).Conclusion The improved method of skin preparation,grade I ASA score,and shortening duration of operation can reduce the incidence of SSI in clean wound orthopedic surgery,on the basis of improving the autoimmunization of patients,strengthening prevention and control of healthcare-associated infection can reduce the incidence of SSI in clean wound orthopedic surgery.

Management and maintenance of clean operation room / 医疗卫生装备

Objective To discuss the management and maintenance of clean operation room. Methods The equipment and operation section in operation room were managed and maintained to meet the requirement of clean operation room. Results Under the management, all indexes reached the standard. Conclusion Only if the importance be attached to the management and maintenance of clean operation room, and the rules be strictly observed, does the clean operation room be well maintained, the hospital infection caused by operating room be effectively controlled and the quality of medical treatment be improved.