The DECREASE SSI Trial (Decolonization to Reduce After-Surgery Events of Surgical Site Infection)

摘要 减少SSI试验(非殖民化以减少手术部位感染的术后事件) 结肠和小肠手术是大容量、高成本的手术，在超过675,000人中进行 美国每年都有病人。这些手术携带最高的手术部位感染(SSI)之一。 利率，估计为11-45%，综合后比全国报告的利率高2至3倍 监测工作也在使用，例如在临床试验中。全面跟踪还揭示了 不成比例的出院后切口性SSI。这些切割性SSI与患者紧密相关 焦虑、压力、尴尬、不满和较低的生活质量得分。 越来越多的证据表明，社会和经济劣势可能会对SSI的风险产生不利影响， 可能是由于出院后保护新鲜伤口免受感染的不同能力所致。这个 非殖民化减少术后手术部位感染事件(降低SSI)试验将检验 在当前的术前和术中预防实践中增加术后干预的价值。 减量SSI试验是一项多点务实的随机对照临床试验，比较常规治疗后。 出院后用洗必泰沐浴和鼻用碘伏非殖民化方案的伤口护理 预防开放结肠和小肠手术出院后30天内的SSI事件。如果成功， 这项试验将为675,000名接受非腹腔镜手术的人提供一种简单的预防措施 每年涉及小肠和大肠的外科手术。

Abstract The DECREASE SSI Trial (Decolonization to Reduce After-Surgery Events of Surgical Site Infection) Colon and small bowel surgery are high-volume, high-cost surgeries performed in over 675,000 patients in the United States each year. These surgeries carry one of the highest surgical site infection (SSI) rates, with estimates of 11-45%, or 2- to 3-fold higher than nationally reported rates, when comprehensive surveillance efforts are used, such as in clinical trials. Comprehensive tracking also uncovers a disproportionate amount of post-discharge incisional SSIs. These incisional SSIs are strongly tied to patient anxiety, stress, embarrassment, dissatisfaction, and lower quality of life scores. Mounting evidence shows that social and economic disadvantage can adversely affect the risk of SSI, likely due to the differential ability to protect a fresh incision from infection after hospital discharge. The Decolonization to Reduce After-Surgery Events of Surgical Site Infection (DECREASE SSI) Trial will test the value of adding a post-operative intervention to current pre-operative and intra-operative prevention practices. The DECREASE SSI Trial is a multi-site pragmatic randomized controlled clinical trial comparing routine post- discharge wound care to a post-discharge decolonization regimen of chlorhexidine bathing and nasal iodophor to prevent SSI events in the 30 days following discharge for open colon and small bowel surgery. If successful, this trial will provide a simple prevention measure for the 675,000 persons who undergo non-laparoscopic surgery involving the small and large intestines each year.