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. 最新伤口护理学. 北京:人民军医出版社, 2008:56-58.
3.	卫生部卫生监督中心. 医院感染诊断标准(试行)[S/OL]. (2001-01-03)[2013-12-23] http://wsbzw.wsjdzx.gov.cn/wsbzw/index.html.
4.	左丽蓉, 刘曼丽. 手术切口感染的预防用抗生素效果分析. 中华外科杂志, 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.	陈烨君, 钱小毛. 开放性骨折患者伤口感染原因分析及预防对策. 中华医院感染学杂志, 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, 黄雅钦, 黄明智. 明胶在创伤敷料中的应用. 明胶科学与技术, 2003, 23(2):57-62.
18.	柯林楠, 冯晓明, 王春仁. 医用敷料研究的现状与进展. 中国组织工程研究与临床康复, 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.	刘德伍. 现代敷料研究现状. 中国临床康复, 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. 最新伤口护理学. 北京:人民军医出版社, 2008:56-58.
3. 卫生部卫生监督中心. 医院感染诊断标准(试行)[S/OL]. (2001-01-03)[2013-12-23] http://wsbzw.wsjdzx.gov.cn/wsbzw/index.html.
4. 左丽蓉, 刘曼丽. 手术切口感染的预防用抗生素效果分析. 中华外科杂志, 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. 陈烨君, 钱小毛. 开放性骨折患者伤口感染原因分析及预防对策. 中华医院感染学杂志, 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, 黄雅钦, 黄明智. 明胶在创伤敷料中的应用. 明胶科学与技术, 2003, 23(2):57-62.
18. 柯林楠, 冯晓明, 王春仁. 医用敷料研究的现状与进展. 中国组织工程研究与临床康复, 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. 刘德伍. 现代敷料研究现状. 中国临床康复, 2002, 6(22):3436-3437.

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RISK FACTOR ANALYSIS OF ACUTE WOUND INFECTION IN ORTHOPEDIC PATIENTS

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