The wound isolation in prevention of abdominal wound infection / 中国综合临床

ABSTRACT

Objective To investigate the effects of the wound isolation in prevention of abdominal wound infection. Methods 2549 patients who bearded abdominal operation in 3 years in our hospital were randomly divid-ed into wound isolation group (n=1300) and control group(n=1249). The wound infection rates were summarized by operation ways and major influencing factors. Results The overall wound infection rate of control group and wound isolation group was 5.9% (76/1300) and 2.6% (32/1249). The infection rate was 13.4% (40/300) and 3.1% (9/280) in gallbladder resection, 14.7 % (24/165) and 3.5 % (6/159) in radical operation for carcinoma of colon, 13.6% (15/108) and 3.2% (13/114) in intestine block operation, 9.6% (18/187) and 1.8% (3/169) in stomach resection (P<0.01);The infection rate was 9.3% (13/145)and 2.9% (4/153)in biliary exploration, 14.6% (8/55) and 1.8% (1/56) in WHIPPLE, 10.6% (9/85) and 2.3% (2/88) in cholecystectomy (P<0.05);The infection rate was 6.3% (6/95) and 2.3% (2/86) in liver resection, 5.3% (5/95) and 1.2% (1/87) in spleen resection, 4.6% (3/65) and 1.8% (1/57) in porto-azygos venous disconnection (P>0.05). The wound infection rate of type Ⅰ resection of control group and wound isolation group was 2.0% (6/305) and 1.4% (4/280) (P> 0.05);The infection rate of type Ⅱ and Ⅲ resection was 7.0% (70/995) and 2.9% (28/969), for old man (≥60) was 12.6% (36/286) and 3.6% (10/279), the emergency operation was 10.0% (38/381) and 2.8% (10/362), the operation time ≥3 h was 9.0% (39/435) and 2.8% (12/426), with diabetes was 14.5% (21/145) and 4.9% (6/123), with obesity was 12.3% (40/325) and 3.9% (12/310), with malnutrition was 8.5% (39/458) and 3.2% (14/433), with cancer was 8.6% (40/465) and 3.0% (15/496) (P<0.01).;undergoing unemergency operation was 4.1% (38/919) and 2.5% (22/887),for yong persons (<60) was 3.9% (40/1014) and 2.3% (22/970), with operation time<3 h was (37/865) and 2.4% (20/823), without diabetes was 3.9% (45/1155) and 2.3 % (26/1126), without obesity was 3.7 % (36/975) and 2.1% (20/939), without malnutrition was 4.4% (37/842) and 2.2% (18/816)and without cancer was 4.3% (36/835) and 2.3% (17/753) (P<0.05). Conclu-sions The wound isolation can decrease the wound infection rates by reducing the chance of bacterial contamina-tion.