Risk Factors for Wound Infection after Spinal Reconstructive Surgery

脊椎重建手術後傷口感染之危險因子

陳力輝(Lih-Huei Chen) ； 洪碩穗(Shuo-Suei Hung) ； 牛自健(Chi-Chien Niu) ； 賴伯亮(Po-Liang Lai) ； 傅再生(Tsai-Sheng Fu) ； 陳文哲(Wen-Jer Chen)

《Formosan Journal of Surgery》 38卷1期 (2005/02) Pp. 1-7

https://doi.org/10.29833/FJS.200502.0001

摘要

脊椎重建手術後産生傷口感染並不常見，但一旦發生，對病患及醫師都非常痛苦，而之後的治療時間不但冗長，醫療資源的花費也很大。此研究乃針對手術後傷口感染之危險因子加以探討。
本研究共收集了於1991年至1997年內接受脊椎手術後，發生傷口感染的30例案例。這些病患在手術前並無感染情況。另外，本研究從同一時段接受脊椎手術，並且無術後感染的兩千多名病患中，以亂數取樣收集了50個案例當控制組。二十一位病患有深部感染，大部份爲男性。平均手術時間，在感染組中有明顯的差異（4.4小時，P＝0.0058）。金黃色葡萄球菌爲最常見的病菌，特別是在深部感染的病患群中。糖尿病以及尿路感染的病患，如同其它文獻所述，都會增加術後傷口感染機率。外傷骨折及過低的血中膽固醇也會增加其機率。
在此回朔性研究中，除了先前文獻上所提到的危險因子之外，我們想強調病患本身營養的重要性，並且對於外傷所造成的骨折要特別注意。

並列摘要

Objectives: Wound infection after spinal reconstructive surgery is an uncommon, but difficult problem for both the patient and the surgeon, and its treatment is unquestionably time-demanding, as well as resource-consuming. This study was conducted with the aim of disclosing the possible risk factors leading to postsurgical wound infections.
Methods: We recruited 30 patients suffering from postoperative spinal infections, from 1991 to 1997, all without pre-existing infection. Fifty out of the total of more than 2000 cases undergoing spinal surgery, with a smooth postoperative course during the same period, were randomly chosen as the control group.
Results: Twenty-one cases had deep wound infections, with a majority of them being males. The mean surgical time was significantly longer in the infected group (4.4 hours, P=0.0058). Staphylococcus aureus was the most commonly found pathogens, especially in the deep infections. Diabetes mellitus and a co-existing urinary tract infection did elevate the risks for infection as mentioned in other reports. An increased rate of infection was found in patients with traumatic fractures and in those who had lower serum cholesterol levels, which additionally implied an inferior nutritional status.
Conclusion: In this retrospective study, other than the previously reported risk factors, we emphasize on the importance of nutritional status, as well as a special precaution in trauma cases.

並列關鍵字

spinal reconstructive surgery ； wound infection ； risk factors