脊柱术后伤口感染.pptx

脊柱术后伤口感染原因及治疗策略北京大学第三医院骨科田耘Surgical Site Infection (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Because the medical,economic and social costs of SSI are enormous， any significant reduction in risks will pay dividends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Surgical Site Infection (SSI)SSI was defined as: any postoperative wound that required treatment with oral or intravenous antibiotics or surgical debridement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Albert F. Pull ter Gunne ? C. J. H. M. van Laarhoven ?David B. Cohen Incidence of surgical site infection following adult spinal deformity surgery: an analysis of patient risk Eur Spine J (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A wound infection was defined as presence of purulence at the operative site and a microbiologic culture positive for one or more organismsJENNIFERB . MASSIE B, S Postoperative Posterior Spinal Wound Infections。Clinical Orthopaedics and Related Research 1992；284：99-108Surgical site infections (SSI) CDC criteria (Centres for Disease Control and prevention)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。An infection was considered to be a surgical site infection when it occured at the site of the surgery within 30 days after the operation or within 1 year if the operation included placement of a foreign body, e.g. an implant.J. J. P. Schimmel ? P. P. Horsting ? M. de Kleuver ?G. Wonders ? J. van Limbeek Risk factors for deep surgical site infections after spinal fusionEur Spine J (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%), Albert F. Pull ter Gunne ? C. J. H. M. van Laarhoven ?David B. Cohen Incidence of surgical site infection following adult spinal deformity surgery: an analysis of patient risk Eur Spine J (2010) 19:982–98836/1,568（ 2.2%）J. J. P. Schimmel ? P. P. Horsting ? M. de Kleuver ?G. Wonders ? J. van Limbee