ERCÝYES ÜNÝVERSÝTESÝ HASTANESÝNDE ORTOPEDÝK CERRAHÝ GÝRÝÞÝMLERDEN SONRA GELÝÞEN CERRAHÝ ALAN ÝNFEKSÝYONLARININ PREVALANSI Prevalence of surgical wound infections following orthopedic surgery at Erciyes University Hospital

Orhan Yýldýz, Emine Alp, Fuat Duygulu, Bilgehan Aygen, Bülent Sümerkan, Mehmet Doðanay
2006 Erciyes Medical Journal)   unpublished
Özet Amaç: Erciyes Üniversitesi Hastanesinde ortopedik cerrahi giriþim sonrasý geliþen cerrahi alan infeksiyonlarýnýn (CAÝ) prevalansýný ve iliþkili risk faktörlerini saptamak, etken mikroorganizmalarý ve mortalite oranlarýný belirlemek Hastalar ve Yöntem: 21-27 Aralýk 2003 tarihleri arasýnda bir haftalýk prevalans çalýþmasý yapýldý. Ortopedik cerrahi geçiren hastalarda CAÝ'nin belirlenmesi ve sýnýflandýrýlmasýnda 'Center for Disease Control' (CDC) tanýmlamalarý kullanýldý. Tüm hastalar
more » ... üm hastalar operasyon sonrasý dönemde dört hafta süreyle izlendi ve geliþen CAÝ kaydedildi. Hastalarýn týbbi kayýtlarý gözden geçirildi ve 12 olasý risk faktörü belirlendi. CAÝ risk faktörlerinin tanýmlamak için istatistiksel analiz yapýldý. Bulgular: Çalýþmaya alýnan 60 hastanýn sekizinde (%13.3) CAÝ geliþti. Saptanan CAÝ'nin hepsi yüzeyel insizyonel CAÝ idi. CAÝ geliþme riski operasyon öncesi yatýþ süresiyle (odds ratio [OR], 1.261; 95% confidence interval [CI], 1.100-1.445; p=0.001) ve antibiyotik profilaksi süresiyle (OR, 1.197; 95% CI, 1.053-1.360; p=0.01) artmaktaydý. Staphylococcus aureus (%36.4) ve Pseudomonas aeruginosa (%27.3)CAÝ geliþen hastalarda en sýk saptanan mikroorganizmalardý. Sonuç: Operasyon öncesi yatýþ süresinin uzun olmasý ve uzun süreli antibiyotik profilaksisi ortopedik cerrahi giriþim sonrasý CAÝ geliþmesiyle baðýmsýz olarak iliþkili risk faktörleriydi. CAÝ geliþmesine katkýda bulunan olasý faktörlerin belirlenmesi ortopedik cerrahi geçiren hastalara en uygun hasta bakýmýnýn verilmesine, mortalitenin ve morbiditenin azalmasýna katkýda bulunacaktýr. Anahtar Kelimeler: Cerrahi yara enfeksiyonlarý; Prevalans; Ortopedik cerrahi; Risk faktörleri. Abstract Purpose: To determine the prevalence of surgical site infections (SSIs) after orthopedic surgery at Erciyes University hospital and to identify associated risk factors, predominant infecting organisms and mortality rates. Patients ad Methods: A week prevalence study was carried out between December 21st and December 27th, 2003. Center for Disease Control criteria were used prospectively to identify cases of SSI in patients who underwent orthopedic surgery. All patients were followed for a four weeks postoperatively and all SSIs were recorded. The complete medical records of each case were reviewed, and data on 12 possible risk factors were extracted. Statistical analyses were performed to identify the risk factors for SSIs. Results: A total of eight postoperative SSIs were identified among 60 cases included in the study, with a resulting overall infection rate of 13.3%. Infection was limited to soft tissue in all cases. The risk of SSI was increased by the duration of preoperative hospitalization (odds ratio [OR], 1.261; 95% confidence interval [CI], 1.100-1.445; p=0.001) and duration of antimicrobial prophylaxis (OR, 1.197; 95% CI, 1.053-1.360; p=0.01). The predominantly isolated microorganisms in patients with SSIs were Staphylococcus aureus (36.4%) and Pseudomonas aeruginosa (27.3%). Conclusion: In orthopedic surgery, longer duration of preoperative hospitalization and antimicrobial prophylaxis were independently associated with SSI after orthopedic surgery. Identification of the risk factors for SSIs will contribute to improve patient care and may decrease mortality and morbidity of orthopedic surgery patients.
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