Analysis of perioperative risk factors for surgical site infection of subaxial cervical spine injury after anterior surgery and the guiding role in nursing care
Li Shuixia, Yang Junsong, Zhao Songchuan, Hao Dingjun, Li Cuicui, Wang Jing, Hu Jing.
Abstract：Objective To investigate the perioperative risk factors of surgical site infection (SSI) of subaxial cervical spine injury after anterior surgery and provide a basis for the development of nursing measures. Methods A retrospective case-control study was conducted to analyze the clinical data of 754 patients with subaxial cervical spine injury who underwent anterior surgery from January 2014 to January 2018, including 511 males and 243 females, aged 44-61 years ［(50.2±5.1)years］. The fracture segment was C3 in 60 patients, C4 in 159, C5 in 197, C6 in 236 patients, and C7 in 102. The patients were divided into two groups according to SSI occurrence. There were 28 patients in infected group and 726 patients in noninfected group. Data of the two groups were recorded, such as demographic data, American Spinal Injury Association (ASIA) scale, comorbidity, time interval from skin preparation to operation, preoperative urinary catheterization or not, consecutive operation or not, total number of staff involved in the operation, layer flow level of operating room, operating room temperature, relative humidity, operation duration, intern nurse involved in the operation or not and surgical methods. Univariate analysis was used to screen the indicators with statistically significant differences between the two groups. Multivariate Logistic regression analysis was further used to identify the risk factors of SSI. Results The occurrence rate of SSI was 3.71% (28/754).The univariate analysis showed that there were significant differences between the two groups in ASIA scale, diabetes, dietary nursing, time interval from skin preparation to operation, preoperative urinary catheterization, consecutive operation, total number of staff involved in the operation, layer flow level of operating room and operation duration(P＜0.01). The multivariate Logistic regression analysis showed that the ASIA scale (grade A：OR= 84.421, grade B：OR=27.200, P＜0.01), diabetes (OR=3.234, P＜0.05), without diet nursing (OR=2.375， P＜0.05), time interval from skin preparation to operation ≥ 6 h (OR=2.542， P＜0.05), preoperative urinary catheterization (OR=4.085, P＜0.01), consecutive operation (OR=2.894, P＜0.05), total number of staff in the operating room ≥ 8 (OR=3.137, P＜0.01), layer flow level of operating room is grade 10,000 or above (OR=5.380, P＜0.01) and operation duration≥ 3 h (OR=2.405, P＜0.05) were positively correlated with perioperative SSI. Conclusions The factors associated with SSI of subaxial cervical spine injury after anterior surgery are the ASIA scale (grade A and B), diabetes, without diet nursing, time interval from skin preparation to operation ≥ 6 h, preoperative urinary catheterization, consecutive operation, total number of staff in the operating room ≥ 8, layer flow level of operating room (grade 10,000 or above) and operation duration ≥3 h. For patients with subaxial cervical spine injury, attention should be paid to diet care, blood glucose monitoring should be strengthened, and operating room management should be optimized.
李水霞 杨俊松 赵松川 郝定均 李翠翠 汪静 胡靖. 下颈椎损伤前路手术切口感染围术期危险因素分析及其对护理的指导作用[J]. 中华创伤杂志, 2020, 36(9): 820-826.
Li Shuixia, Yang Junsong, Zhao Songchuan, Hao Dingjun, Li Cuicui, Wang Jing, Hu Jing.. Analysis of perioperative risk factors for surgical site infection of subaxial cervical spine injury after anterior surgery and the guiding role in nursing care. CHINESE JOURNAL OF TRAUMA, 2020, 36(9): 820-826.
