RISK FACTOR ANALYSIS OF ACUTE WOUND INFECTION IN ORTHOPEDIC PATIENTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 NINGNing ¹ , LüJuan ² , HELingxiao ¹ , WANGYaqin ¹ , LIAODengbin ¹ , CHENJiali ¹

1. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China;
2. Department of Geriactrics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China;

Corresponding?author：

NINGNing, Email: gkningning@126.com

Keywords：

Orthopedics; Acute wound; Infection; Risk factor

DOI：

10.7507/1002-1892.20140159

Video：

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Objective To analyze the risk factors of acute wound infection in orthopedic patients. Methods A retrospective analysis was made on the clinical data of 576 orthopedic patients in accordance with the inclusion criteria between July and October 2012. There were 345 males and 231 females, aged 18-95 years (mean, 44 years). Single factor analysis was used for related factors, and logistic regression analysis of multi-factors for risk factors of acute wound infection. Results Wound infection occurred in 73 of 576 patients (12.7%). Single factor analysis showed that the influence factors were gender, education, smoking history, nutritional status (hemoglobin, red blood cell count, serum albumin, and total serum protein), blood glucose level, shock history, wound situation (characteristics, multiple injuries, and cleaning), type of injuries, the time of trauma handling, antibiotic use, whether to stay in ICU, wound pain score, drug analgesia, patient controlled analgesia, and dressings and cleaning solution choice. The logistic regression analysis showed that the gender, time of trauma handling, blood glucose level, wound pain score, dressing choice, and wound characteristics were the risk factors of acute wound infection (P<0.05). Conclusion To achieve the best results in clinical prevention of infection, these risk factors (gender, the time of trauma handling, blood glucose level, wound pain score, dressing choice, and wound characteristics) should be considered well.

Citation： NINGNing, LüJuan, HELingxiao, WANGYaqin, LIAODengbin, CHENJiali. RISK FACTOR ANALYSIS OF ACUTE WOUND INFECTION IN ORTHOPEDIC PATIENTS. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(6): 714-717. doi: 10.7507/1002-1892.20140159 Copy

1.	Vowden P, Vowden K. Is the EWMA position document on diagnosing infection being implemented:results of a district-wide audlt? EWMA J, 2009, 9(3):32-33.
2.	于博芮, 蔡新中. 最新傷口護理學. 北京:人民軍醫出版社, 2008:56-58.
3.	衛生部衛生監督中心. 醫院感染診斷標準(試行)[S/OL]. (2001-01-03)[2013-12-23] http://wsbzw.wsjdzx.gov.cn/wsbzw/index.html.
4.	左麗蓉, 劉曼麗. 手術切口感染的預防用抗生素效果分析. 中華外科雜志, 2003, 41(3):188.
5.	Freeman ML, Nelson DB, Sherman S, et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med, 1996, 335(13):909-918.
6.	陳燁君, 錢小毛. 開放性骨折患者傷口感染原因分析及預防對策. 中華醫院感染學雜志, 2011, 21(1):64-65.
7.	Bernal NP, Latenser BA, Born JM, et al. Trends in 393 necrotizing acute soft tissue infection patients 2000-2008. Burns, 2012, 38(2):252-260.
8.	Mirshamsi MH, Ayatollahi J, Dashti-R MH. A comparison between traumatic wound infections after irrigating them with tap water and normal saline. World Journal of Medical Sciences, 2007, 2(1):58-61.
9.	Boltz MM, Hollenbeak CS, Julian KG, et al. Hospital costs associated with surgical site infections in general and vascular surgery patients. Surgery, 2011, 150(5):934-942.
10.	Anusha S, Vijaya LD, Pallavi K, et al. An epidemiological study of surgical wound infections in a surgical unit of tertiary care teaching hospital. Indian Journal of Pharmacy Practice, 2010, 3(4):8-13.
11.	Laird AM, Miller PR, Kilgo PD, et al. Relationship of early hyperglycemia in trauma patients. J Trauma, 2004, 56(5):1058-1062.
12.	Kim BO, Kim SW, Lee SM, et al. Relationship of glucose control and wound infection in diabetics after lumbar spine surgery. J Korean Neurosurg Soc, 2005, 37(1):44-47.
13.	Morgan WJ, Hutchison D, Johnson HM. The delayed treatment of wounds of the hand and forearm under antibiotic cover. Br J Surg, 1980, 67(2):140-141.
14.	Hollander JE, Singer AJ, Valentine SM, et al. Risk factors for infection in patients with traumatic lacerations. Acad Emerg Med, 2001, 8(7):716-720.
15.	Woo KY, Harding K, Price P, et al. Minimising wound-related pain at dressing change:evidence-informed practice. Int Wound J, 2008, 5(2):144-157.
16.	Cooper R. Identifying criteria for wound infection EWMA position document. London:MEP Ltd, 2005:2-5.
17.	李承明, 黃雅欽, 黃明智. 明膠在創傷敷料中的應用. 明膠科學與技術, 2003, 23(2):57-62.
18.	柯林楠, 馮曉明, 王春仁. 醫用敷料研究的現狀與進展. 中國組織工程研究與臨床康復, 2010, 14(3):521-524.
19.	Ovington LG. Hanging wet-to-dry dressings out to dry. Home Healthc Nurse, 2001, 19(8):477-484.
20.	Whitney J, Phillips L, Aslam R, et al. Guidelines for the treatment of pressure ulcers. Wound Repair Regener, 2007, 14(6):663-679.
21.	劉德伍. 現代敷料研究現狀. 中國臨床康復, 2002, 6(22):3436-3437.

1. Vowden P, Vowden K. Is the EWMA position document on diagnosing infection being implemented:results of a district-wide audlt? EWMA J, 2009, 9(3):32-33.
2. 于博芮, 蔡新中. 最新傷口護理學. 北京:人民軍醫出版社, 2008:56-58.
3. 衛生部衛生監督中心. 醫院感染診斷標準(試行)[S/OL]. (2001-01-03)[2013-12-23] http://wsbzw.wsjdzx.gov.cn/wsbzw/index.html.
4. 左麗蓉, 劉曼麗. 手術切口感染的預防用抗生素效果分析. 中華外科雜志, 2003, 41(3):188.
5. Freeman ML, Nelson DB, Sherman S, et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med, 1996, 335(13):909-918.
6. 陳燁君, 錢小毛. 開放性骨折患者傷口感染原因分析及預防對策. 中華醫院感染學雜志, 2011, 21(1):64-65.
7. Bernal NP, Latenser BA, Born JM, et al. Trends in 393 necrotizing acute soft tissue infection patients 2000-2008. Burns, 2012, 38(2):252-260.
8. Mirshamsi MH, Ayatollahi J, Dashti-R MH. A comparison between traumatic wound infections after irrigating them with tap water and normal saline. World Journal of Medical Sciences, 2007, 2(1):58-61.
9. Boltz MM, Hollenbeak CS, Julian KG, et al. Hospital costs associated with surgical site infections in general and vascular surgery patients. Surgery, 2011, 150(5):934-942.
10. Anusha S, Vijaya LD, Pallavi K, et al. An epidemiological study of surgical wound infections in a surgical unit of tertiary care teaching hospital. Indian Journal of Pharmacy Practice, 2010, 3(4):8-13.
11. Laird AM, Miller PR, Kilgo PD, et al. Relationship of early hyperglycemia in trauma patients. J Trauma, 2004, 56(5):1058-1062.
12. Kim BO, Kim SW, Lee SM, et al. Relationship of glucose control and wound infection in diabetics after lumbar spine surgery. J Korean Neurosurg Soc, 2005, 37(1):44-47.
13. Morgan WJ, Hutchison D, Johnson HM. The delayed treatment of wounds of the hand and forearm under antibiotic cover. Br J Surg, 1980, 67(2):140-141.
14. Hollander JE, Singer AJ, Valentine SM, et al. Risk factors for infection in patients with traumatic lacerations. Acad Emerg Med, 2001, 8(7):716-720.
15. Woo KY, Harding K, Price P, et al. Minimising wound-related pain at dressing change:evidence-informed practice. Int Wound J, 2008, 5(2):144-157.
16. Cooper R. Identifying criteria for wound infection EWMA position document. London:MEP Ltd, 2005:2-5.
17. 李承明, 黃雅欽, 黃明智. 明膠在創傷敷料中的應用. 明膠科學與技術, 2003, 23(2):57-62.
18. 柯林楠, 馮曉明, 王春仁. 醫用敷料研究的現狀與進展. 中國組織工程研究與臨床康復, 2010, 14(3):521-524.
19. Ovington LG. Hanging wet-to-dry dressings out to dry. Home Healthc Nurse, 2001, 19(8):477-484.
20. Whitney J, Phillips L, Aslam R, et al. Guidelines for the treatment of pressure ulcers. Wound Repair Regener, 2007, 14(6):663-679.
21. 劉德伍. 現代敷料研究現狀. 中國臨床康復, 2002, 6(22):3436-3437.

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