scrubbing technique

  • 文章类型: Journal Article
    背景:内镜手术现在越来越多地取代泌尿外科的开放手术。传统上,由于泌尿生殖道被微生物区系定植,因此泌尿生殖道被归类为清洁污染,即使在无菌尿液的情况下。这项研究的目的是确定在手术前使用标准擦洗和部分擦洗技术进行简短的腔内手术后感染率是否存在差异。患者和方法:这是一项对397例患者进行短期腔内手术的回顾性分析,所有手术持续时间<30分钟。将患者分为使用全擦洗技术进行手术的第一组和使用部分擦洗技术进行手术的第二组。随访所有患者尿路感染(UTIs)的发生情况。比较两组的年龄,性别,和UTI的术后发展。p<0.05的值被认为是统计学上显著的。结果:在397例患者中,200和197使用全擦洗和部分擦洗技术进行了手术,分别。女性和男性分别占142例(35.8%)和255例(64.2%),分别。只有18例(4.5%)患者发生了记录的UTI和抗生素处方。在18例诊断为术后尿路感染的患者中,10例(55.5%)进行了部分擦洗手术,8例(45.5%)进行了完全擦洗手术(p=0.638)。结论:我们的发现表明,在进行简短的腔内手术后发生UTI的风险与术前使用的擦洗技术(部分或全部擦洗)之间没有任何显着关系。
    Background: Endoscopic surgery is now increasingly taking the place of open surgery in urology. Traditionally, endourological procedures are classified as clean-contaminated because the genitourinary tract is colonized by micro-flora, even in the case of sterile urine. The aim of this study was to determine whether a difference occurs in the infection rate after short endourological procedures using standard scrubbing and partial scrubbing techniques before the operations. Patients and Methods: This was a retrospective analysis of 397 patients who underwent a short endourological procedure, with all procedure durations lasting <30 min. Patients were divided into a first group who underwent operations using a full-scrub technique and a second group who underwent operations using a partial-scrub technique. All patients were followed up for the occurrence of urinary tract infections (UTIs). Both groups were compared for age, gender, and post-operative development of UTIs. Values of p < 0.05 were considered statistically significant. Results: Of the 397 patients, 200 and 197 underwent their procedures using the full-scrub and partial-scrub techniques, respectively. Females and males accounted for 142 (35.8%) and 255 (64.2%) patients, respectively. Only 18 (4.5%) patients developed documented UTIs and antibiotics were prescribed. Of the 18 patients diagnosed with post-operative UTIs, 10 (55.5%) had undergone partial-scrub operations and 8 (45.5%) had undergone full-scrub operations (p = 0.638). Conclusion: Our findings did not indicate any significant relationship between the risk of developing UTI after a short endourological procedure and the scrub technique used before the operation (partial or full scrub).
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  • 文章类型: Journal Article
    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。
    OBJECTIVE: 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.
    METHODS: 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.
    RESULTS: 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.
    CONCLUSIONS: There is no evidence to suggest that perioperative infection is associated with personal scrubbing or gloving preference in neurosurgical procedures.
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