目的:喉气管(LT)手术后手术部位感染(SSI)的发生率相对较高,尤其是儿童。
方法:回顾性和前瞻性队列研究。
方法:回顾了2008年1月至2017年8月在IstitutoGianninaGaslini儿童医院接受开放式LT手术的儿童的临床记录,以了解SSI的发展。直到2015年2月才进行标准抗生素预防。2015年3月,针对从监测培养物中分离出的病原体进行了抗生素治疗,并延长了直到拔管的时间。通过单变量和多变量分析,分析了新方案实施前后SSI的发生率和危险因素。
结果:共分析了57例手术。接受标准预防的患者的SSI发生率为36%,接受新策略治疗的患者为4%(P=.004),绝对收益增加32%(95%置信区间:11%-52%),两组之间的临床状况没有任何差异。
结论:新的管理方案对SSI的发展产生了非常有利的影响。
方法:2b喉镜,129:2634-2639,2019年。
OBJECTIVE: Incidence of surgical site infection (SSI) after laryngotracheal (LT) surgery is relatively high, especially in children.
METHODS: Retrospective and prospective cohort study.
METHODS: Clinical records of children who underwent open LT surgery at the Istituto Giannina Gaslini Children\'s Hospital from January 2008 to August 2017 were reviewed for development of SSI. Standard antibiotic prophylaxis was administered until February 2015. In March 2015, an antibiotic treatment tailored on pathogens isolated from surveillance cultures and prolonged until extubation was introduced. Incidence and risk factors for SSI before and after the new protocol implementation were analyzed by means of univariate and multivariable analyses.
RESULTS: A total of 57 procedures were analyzed. SSI incidence was 36% in patients receiving standard prophylaxis and 4% in those treated with the new strategy (P = .004), with an absolute benefit increase of 32% (95% confidence interval: 11%-52%), in absence of any difference in clinical conditions between the two groups.
CONCLUSIONS: The new management protocol had a highly favorable impact on the development of an SSI.
METHODS: 2b Laryngoscope, 129:2634-2639, 2019.