脊柱术后伤口感染ppt课件

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1、脊柱术后伤口感染原因及治疗策略SurgicalSiteInfection(SSI)SSI意味着医生的痛苦、患者的眼泪高病残率，成倍增加的花费Becausethemedical,economicandsocialcostsofSSIareenormous，anysignificantreductioninriskswillpaydividends内容摘要定义流行病学影响因素病原学预防治疗措施需要关注的问题SurgicalSiteInfection(SSI)SSIwasdefinedas:anypostoperativewoundthatrequiredtreatment

2、withoralorintravenousantibioticsorsurgicaldebridement任何术后伤口需要进行口服或静脉使用抗生素，或者需要外科手术清理者AlbertF.PullterGunne•C.J.H.M.vanLaarhoven•DavidB.CohenIncidenceofsurgicalsiteinfectionfollowingadultspinaldeformitysurgery:ananalysisofpatientriskEurSpineJ(2010)19:982–988SSI的定义手术区出现渗出，可培养出一种或多种致病菌Awoun

3、dinfectionwasdefinedaspresenceofpurulenceattheoperativesiteandamicrobiologicculturepositiveforoneormoreorganismsJENNIFERB.MASSIEB,SPostoperativePosteriorSpinalWoundInfections。ClinicalOrthopaedicsandRelatedResearch1992；284：99-108Surgicalsiteinfections(SSI)CDCcriteria(CentresforDiseaseCo

4、ntrolandprevention)手术区域的感染发生于术后30天内，或有内固定的患者术后1年内出现的感染。Aninfectionwasconsideredtobeasurgicalsiteinfectionwhenitoccuredatthesiteofthesurgerywithin30daysaftertheoperationorwithin1yeariftheoperationincludedplacementofaforeignbody,e.g.animplant.J.J.P.Schimmel•P.P.Horsting•M.deKleuver•G.Wond

5、ers•J.vanLimbeekRiskfactorsfordeepsurgicalsiteinfectionsafterspinalfusionEurSpineJ(2010)19:1711–1719流行病学无内固定0.41%(25/6108),有内固定者感染发生率为1.0%(11/1112),总体感染发生率为0.5%(36/7220)田耘　陈仲强　周方　刘忠军脊柱术后伤口深部感染的处理中华外科杂志2005；43：229-2311.61%（15/924）仉建国李书纲杨新宇田野邱贵兴脊柱侧凸后路矫形融合术术后感染的治疗中华骨科杂志2001；21：453-456流行病学手

6、术切口区感染是脊柱手术经常出现的并发症发生率，文献报道0.7～12%。46/830(5.0%),AlbertF.PullterGunne•C.J.H.M.vanLaarhoven•DavidB.CohenIncidenceofsurgicalsiteinfectionfollowingadultspinaldeformitysurgery:ananalysisofpatientriskEurSpineJ(2010)19:982–98836/1,568（2.2%）J.J.P.Schimmel•P.P.Horsting•M.deKleuver•G.Wonders•J.va

7、nLimbeekRiskfactorsfordeepsurgicalsiteinfectionsafterspinalfusionEurSpineJ(2010)19:1711–1719SSI的危险因素高龄肥胖糖尿病其他伴随疾病吸烟身体状况差完全的神经功能损伤SSI的高危因素-手术因素翻修手术肿瘤手术出血多手术时间长多节段危险因素Obesity(P=0.035)andhistoryofpriorSSI(P=0.045)significantlyincreasedtheriskofSSIAlbertF.PullterGunne•C.J.H.M.vanLa