Abstract：
The preoperative scrub has been shown to lower the incidence of surgical site infections (SSIs). Various scrubbing and gloving techniques exist; however, it is unknown how specific scrubbing technique influences SSI rates in neurosurgery. The authors aimed to assess whether the range of scrubbing practice in neurosurgery is associated with the incidence of SSIs.
The authors conducted a retrospective review of a prospectively maintained database to identify all 90-day SSIs for neurosurgical procedures between 2012 and 2017 at one of their teaching hospitals. SSIs were classified by procedure type (craniotomy, shunt, fusion, or laminectomy). Surveys were administered to attending and resident physicians to understand the variation in scrubbing methods (wet vs dry, iodine vs chlorhexidine, single vs double glove). The chi-square followed by multivariate logistic regression analyses were utilized to identify independent predictors of SSI.
Forty-two operating physicians were included in the study (18 attending physicians, 24 resident physicians), who performed 14,200 total cases. Overall, SSI rates were 2.1% (296 SSIs of 14,200 total cases) and 2.0% (192 of 9,669 cases) for attending physicians and residents, respectively. Shunts were independently associated with an increased risk of SSI (OR 1.7 [95% CI 1.3-2.1]), whereas laminectomies were associated with a decreased SSI risk (OR 0.4 [95% CI 0.2-0.8]). Wet versus dry scrub (OR 0.9 [95% CI 0.6-1.4]), iodine versus chlorhexidine (OR 0.6 [95% CI 0.4-1.1]), and single- versus double-gloving (OR 1.1 [95% CI 0.8-1.4]) preferences were not associated with SSIs.
There is no evidence to suggest that perioperative infection is associated with personal scrubbing or gloving preference in neurosurgical procedures.
The authors conducted a retrospective review of a prospectively maintained database to identify all 90-day SSIs for neurosurgical procedures between 2012 and 2017 at one of their teaching hospitals. SSIs were classified by procedure type (craniotomy, shunt, fusion, or laminectomy). Surveys were administered to attending and resident physicians to understand the variation in scrubbing methods (wet vs dry, iodine vs chlorhexidine, single vs double glove). The chi-square followed by multivariate logistic regression analyses were utilized to identify independent predictors of SSI.
Forty-two operating physicians were included in the study (18 attending physicians, 24 resident physicians), who performed 14,200 total cases. Overall, SSI rates were 2.1% (296 SSIs of 14,200 total cases) and 2.0% (192 of 9,669 cases) for attending physicians and residents, respectively. Shunts were independently associated with an increased risk of SSI (OR 1.7 [95% CI 1.3-2.1]), whereas laminectomies were associated with a decreased SSI risk (OR 0.4 [95% CI 0.2-0.8]). Wet versus dry scrub (OR 0.9 [95% CI 0.6-1.4]), iodine versus chlorhexidine (OR 0.6 [95% CI 0.4-1.1]), and single- versus double-gloving (OR 1.1 [95% CI 0.8-1.4]) preferences were not associated with SSIs.
There is no evidence to suggest that perioperative infection is associated with personal scrubbing or gloving preference in neurosurgical procedures.
摘要：
目的：术前擦洗可降低手术部位感染（SSIs）的发生率。存在各种擦洗和手套技术；但是，目前尚不清楚特定的擦洗技术如何影响神经外科手术中的SSI率。作者旨在评估神经外科中擦洗练习的范围是否与SSIs的发生率相关。
方法：作者对前瞻性维护的数据库进行了回顾性审查，以确定2012年至2017年在其教学医院进行的所有90天神经外科手术的SSI。SSIs按手术类型分类(开颅手术，分流,聚变,或椎板切除术）。对主治医师和住院医师进行了调查，以了解擦洗方法的变化(湿与干，碘与氯己定，单vs双手套)。卡方和多元逻辑回归分析用于确定SSI的独立预测因子。
结果：42名手术医师被纳入研究（18名主治医师，24名住院医师)，共执行了14,200起案件。总的来说,主治医师和住院医师的SSI率分别为2.1％（总共14,200例，296例）和2.0％（9,669例，192例），分别。分流与SSI风险增加独立相关(OR1.7[95%CI1.3-2.1])，而椎板切除术与SSI风险降低相关(OR0.4[95%CI0.2-0.8]).湿磨砂与干磨砂（OR0.9[95%CI0.6-1.4]），碘与氯己定（OR0.6[95%CI0.4-1.1]），单手套和双手套(OR1.1[95%CI0.8-1.4])偏好与SSIs无关。
结论：在神经外科手术中，没有证据表明围手术期感染与个人擦洗或手套偏好相关。
方法：作者对前瞻性维护的数据库进行了回顾性审查，以确定2012年至2017年在其教学医院进行的所有90天神经外科手术的SSI。SSIs按手术类型分类(开颅手术，分流,聚变,或椎板切除术）。对主治医师和住院医师进行了调查，以了解擦洗方法的变化(湿与干，碘与氯己定，单vs双手套)。卡方和多元逻辑回归分析用于确定SSI的独立预测因子。
结果：42名手术医师被纳入研究（18名主治医师，24名住院医师)，共执行了14,200起案件。总的来说,主治医师和住院医师的SSI率分别为2.1％（总共14,200例，296例）和2.0％（9,669例，192例），分别。分流与SSI风险增加独立相关(OR1.7[95%CI1.3-2.1])，而椎板切除术与SSI风险降低相关(OR0.4[95%CI0.2-0.8]).湿磨砂与干磨砂（OR0.9[95%CI0.6-1.4]），碘与氯己定（OR0.6[95%CI0.4-1.1]），单手套和双手套(OR1.1[95%CI0.8-1.4])偏好与SSIs无关。
结论：在神经外科手术中，没有证据表明围手术期感染与个人擦洗或手套偏好相关。
