Statistical Analysis of Surgical Site Infection After Head and Neck Reconstructive Surgery
Statistical Analysis of Surgical Site Infection After Head and Neck Reconstructive Surgery
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DOI：
10.1245/s10434-014-3498-8
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发表时间：
2014-05-01
影响因子：
3.7
通讯作者：
Hayashi, Ryuichi
中科院分区：
文献类型：
--
作者：
Kamizono, Kenichi;Sakuraba, Minoru;Hayashi, Ryuichi
手术部位感染（SSI）在头颈部重建后的发生率超过40%，部分原因是清洁污染的手术野，其中皮肤野与口腔或咽野相互作用。本研究的目的是澄清SSI的最重要的危险因素，并确定有效的策略，以防止SSI.In 2011年和2012年，197例接受头颈部重建手术的患者进行了研究，在国立癌症中心医院东，日本。对SSI发生率、SSI的危险因素和SSI的生物学方面进行了前瞻性评价。共有42名患者（21.3%）发生SSI，在感染部位鉴定出62种细菌。多变量分析确定的SSI的显著风险因素为低白蛋白血症[P = 0.002，比值比（OR）= 3.37]、血管化骨转移重建（P = 0.006，OR = 3.99）和美国麻醉医师协会身体状况评分较差（P = 0.041，OR = 3.00）。大多数被鉴定的细菌是持续存在于皮肤和咽部区域的细菌，但多重耐药细菌很少。为了最大限度地减少SSI，应考虑采取干预措施改善患者的围手术期营养状况和更合适的下颌骨重建策略。
Surgical site infections (SSIs) occur at a rate exceeding 40 % after head and neck reconstruction and are due in part to the clean-contaminated surgical field, in which cutaneous fields interact with oral or pharyngeal fields. The aim of this study was to clarify the most important risk factors for SSI and to identify effective strategies for preventing SSI.In 2011 and 2012, 197 patients who underwent head and neck reconstructive surgery were studied at National Cancer Center Hospital East, Japan. The SSI rate, risk factors for SSI, and biological aspects of SSI were evaluated prospectively.A total of 42 patients (21.3 %) had SSIs, and 62 bacterial species were identified at infection sites. Significant risk factors for SSI identified with multivariate analysis were hypoalbuminemia [P = 0.002, odds ratio (OR) = 3.37], reconstruction with vascularized bone transfer (P = 0.006, OR = 3.99), and a poor American Society of Anesthesiologists Physical Status score (P = 0.041, OR = 3.00). Most bacteria identified were species that persist around cutaneous and pharyngeal fields, but multidrug-resistant bacteria were rare.The SSI rate at our hospital is lower than rates in previous studies. To minimize SSI, intervention to improve the patient's perisurgical nutritional status and a more appropriate mandible reconstructive strategy should be considered.