下肢创面皮瓣修复术后院内切口感染情况及其影响因素分析

doi:10.3969/j.issn.1006-6233.2021.11.020

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Abstract Objective: To investigate the infection of the nosocomial incision and its influencing factors after the repair of the lower limb wound flap. Methods: 282 patients who underwent lower extremity wound flap repair in our hospital from January 2017 to December 2020 were selected for retrospective analysis. The factors that may affect the nosocomial incision infection were collected. According to the presence or absence of nosocomial incision infection, the patients were divided into infected group and uninfected group. The medical records of the two groups were compared, and the factors with significant differences in univariate analysis were comprehensively analyzed by multivariate logistic regression analysis. Results: A total of 23 of the 282 patients undergoing skin flap repair of lower limb wounds included in this study had incision infection, and the infection rate was 8.16%. A total of 36 pathogenic bacteria were isolated and cultured in 23 patients, of which gram-positive bacteria accounted for 61.11%, gram-negative bacteria accounted for 33.33%, and fungi accounted for 5.56%.On the basis of univariate analysis and multivariate analysis, the results showed that the risk factors of nosocomial incision infection after lower limb skin flap repair were the prolongation of post injury visit time, operation time, hospital stay, glucocorticoid use and diabetes history, and the protective factors were the skin lesion area more than 10% of the wound area and the use of preventive antibiotics (P<0.05). Conclusion: The rate of nosocomial incision infection after lower limb skin flap repair is high, mainly Gram-positive infection, which is mainly affected by the time of treatment, operation time, hospital stay and other factors. In clinical practice, targeted intervention can be carried out for the above factors to reduce the incidence of nosocomial incision infection in such patients.

Key words： Lower extremity wounds Flap repair Nosocomial incision infection Multivariate analysis

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	PU Xiaoshu
	JIANG Ting
	ZHANG Lanfang
	et al

Cite this article:

PU Xiaoshu,JIANG Ting,ZHANG Lanfang, et al. Analysis of Infection of Nosocomial Incision and Its Influencing Factors after Repair of Lower Extremity Wound Skin Flap[J]. HeBei Med, 2021, 27(11): 1866-1871.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.11.020 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I11/1866

[1] 刘新萍,吕若君,刘新苗,等.下肢皮肤缺损行负压封闭引流术后的感染风险分析[J].中华医院感染学杂志,2018,28(17):86~89.
[2] Rosengren H,Heal C F,Buettner P G.Effect of a single preoperative dose of oral antibiotic to reduce the incidence of surgical site infection following below-knee dermatological flap and graft repair[J].Dermatol Pract Concep,2019,9(1):28~32.
[3] 刘林军.皮瓣移植修复32例下肢外伤性深部组织外露刨面的体会[J].医学美学美容,2018,27(18):68~69.
[4] Hakan A,AAnil D.Comparison of subacute and delayed free flap reconstruction in the treatment of open lower extremity fractures.[J].Ulus Travma Acil Cerrahi Derg,2019,25(2):188~192.
[5] Olesen U K,Pedersen N J,Eckardt H,et al.The cost of infection in severe open tibial fractures treated with a free flap[J].Int Orthop,2017,41(5):1049~1055.
[6] 中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,7(5):61~67.
[7] 曾御,陈世玖.皮瓣修复手部软组织缺损的研究进展[J].医学综述,2018,4(24):142~145.
[8] Nickl S,Steindl J,Langthaler D,et al.First experiences with incisional negative pressure wound therapy in a high-risk poststernotomy patient population treated with pectoralis major muscle flap for deep sternal wound infection[J].Reconstr Microsurgery,2018,34(1):1~7.
[9] Al-Hourani K,Fowler T,Whitehouse M R,et al.Two-stage combined ortho-plastic management of type IIIB open diaphyseal tibial fractures requiring flap coverage:Is the timing of debridement and coverage associated with outcomes[J].Orthop Trauma,2019,33(12):591~597.
[10] Jeong T S,Yee G T.Prospective multicenter surveillance study of surgical site infection after intracranial procedures in Korea:a preliminary study[J].Korean Neurosurg S,2018,61(5):645~69.
[11] Tubre D J,Schroeder A D,Estes J,et al.Surgical site infection:the "Achilles Heel" of all types of abdominal wall hernia reconstruction[J].Hernia,2018,22(6):1003~1013.
[12] Pan T,Li K,Fan F D,et al.Vacuum-assisted closure vs.bilateral pectoralis major muscle flaps for deep sternal wounds infection[J].Thoracic Dis,2020,12(3):866~868.
[13] Rikimaru H,Rikimaru-Nishi Y,Yamauchi D,et al.New alternative therapeutic strategy for gustilo type IIIB open fractures,using an intra-wound continuous negative pressure irrigation treatment system[J]. Kurume medical,2018,65(4):177~183.
[14] Karamanos E,Kandagatla P,Watson J,et al.Development and validation of a scoring system to predict surgical site infection after ventral hernia repair:a Michigan surgical quality collaborative study[J].World Sur,2017,41(4):914~918.
[15] Abode-Iyamah K O,Chiang H Y,Winslow N,et al.Risk factors for surgical site infections and assessment of vancomycin powder as a preventive measure in patients undergoing first-time cranioplasty[J].Neurosurgerg,2018,128(4):1241~1249.