Post-operative Wound Care Protocol Prevents Surgical Site Infection After Craniotomy

医学 开颅术 伤口护理 外科 葡萄糖酸洗必泰 感染控制 麻醉 洗必泰 牙科
作者
Mariya Kovryga Kornick,Eunjung Lee,Lisa Wilhelm,Janicé White,Oh‐Hyun Cho,Frank P.K. Hsu,Jefferson W. Chen,Susan S. Huang
出处
期刊:American Journal of Infection Control [Elsevier BV]
卷期号:50 (7): S36-S36
标识
DOI:10.1016/j.ajic.2022.03.061
摘要

Background Surgical Site Infections (SSIs) following craniotomy may be affected by extensive head vasculature. Attentive post-operative wound care to keep hair away, cleanse skin, and remove incisional clots that provide nutrients for organisms may help prevent SSIs. Methods In 2018, 72% of craniotomy SSIs at an academic medical center were related to post-operative wound disruption, drainage, and compromised wound healing. These SSIs involved Gram-positive organisms, consistent with skin flora. In January 2019, a post-operative wound care protocol developed by neurosurgical nurse and wound care specialists, and the infection prevention program was initiated, involving 1) soft bands to keep the incision clear of hair, and 2) 2% chlorhexidine gluconate (CHG) cloths to clean the incision and the proximal 6-inches of any drains, remove incisional clots, and clean adjacent skin and hair within 2 inches of the incision. Twice-weekly photos were taken of post-operative craniotomy wounds with protocol lapses and real-time feedback was provided to the bedside nurse, wound care nurse, and surgeon from February 2019-February 2020. Due to the Coronavirus Disease 2019 pandemic (COVID-19), the program progressively lapsed until January 2021, when it was reinstated. SSI rates were compared during the periods with and without the intervention using a chi-square test. Results Baseline Craniotomy SSI rate prior to January 2019 was 3.8% (5/133, SIR=2.6) and 1.7% (16/952, SIR=1.1) during the first intervention period. During COVID-19 surge, SSIs increased to 3.6% (5/140, SIR=2.3) without the intervention, and were restored to a lower rate, 1.6% (2/128, SIR=0.9) after the intervention was reinstituted. SSI rates were lower in intervention (1.7% (18/1080)) versus non-intervention periods (3.7% (10/273)), p=0.04. Conclusions A post-operative inpatient craniotomy wound care protocol involving hair care, incisional CHG cleansing and clot removal, plus photo documentation and feedback for protocol adherence was associated with SSI reduction. Surgical Site Infections (SSIs) following craniotomy may be affected by extensive head vasculature. Attentive post-operative wound care to keep hair away, cleanse skin, and remove incisional clots that provide nutrients for organisms may help prevent SSIs. In 2018, 72% of craniotomy SSIs at an academic medical center were related to post-operative wound disruption, drainage, and compromised wound healing. These SSIs involved Gram-positive organisms, consistent with skin flora. In January 2019, a post-operative wound care protocol developed by neurosurgical nurse and wound care specialists, and the infection prevention program was initiated, involving 1) soft bands to keep the incision clear of hair, and 2) 2% chlorhexidine gluconate (CHG) cloths to clean the incision and the proximal 6-inches of any drains, remove incisional clots, and clean adjacent skin and hair within 2 inches of the incision. Twice-weekly photos were taken of post-operative craniotomy wounds with protocol lapses and real-time feedback was provided to the bedside nurse, wound care nurse, and surgeon from February 2019-February 2020. Due to the Coronavirus Disease 2019 pandemic (COVID-19), the program progressively lapsed until January 2021, when it was reinstated. SSI rates were compared during the periods with and without the intervention using a chi-square test. Baseline Craniotomy SSI rate prior to January 2019 was 3.8% (5/133, SIR=2.6) and 1.7% (16/952, SIR=1.1) during the first intervention period. During COVID-19 surge, SSIs increased to 3.6% (5/140, SIR=2.3) without the intervention, and were restored to a lower rate, 1.6% (2/128, SIR=0.9) after the intervention was reinstituted. SSI rates were lower in intervention (1.7% (18/1080)) versus non-intervention periods (3.7% (10/273)), p=0.04. A post-operative inpatient craniotomy wound care protocol involving hair care, incisional CHG cleansing and clot removal, plus photo documentation and feedback for protocol adherence was associated with SSI reduction.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
123完成签到,获得积分10
1秒前
2秒前
单耳兔完成签到 ,获得积分10
2秒前
潇湘雪月发布了新的文献求助10
2秒前
故意的靳完成签到,获得积分10
4秒前
mzhmhy完成签到,获得积分10
4秒前
bkagyin应助wish采纳,获得10
8秒前
Afaq发布了新的文献求助10
8秒前
果粒多发布了新的文献求助10
9秒前
9秒前
无辜如容完成签到,获得积分10
10秒前
10秒前
13秒前
14秒前
ASA发布了新的文献求助30
14秒前
15秒前
情怀应助tingting9采纳,获得10
16秒前
FXQ123_范发布了新的文献求助10
16秒前
sun完成签到,获得积分20
16秒前
18秒前
彭于晏应助wldsd采纳,获得30
18秒前
量子星尘发布了新的文献求助10
18秒前
19秒前
19秒前
高一淼发布了新的文献求助10
20秒前
明道若昧完成签到,获得积分10
20秒前
上官若男应助mk采纳,获得10
21秒前
wish完成签到,获得积分10
23秒前
wish发布了新的文献求助10
25秒前
稍等一下完成签到 ,获得积分10
26秒前
momo发布了新的文献求助10
26秒前
28秒前
28秒前
liang白开完成签到,获得积分10
30秒前
mk发布了新的文献求助10
32秒前
丘比特应助嗯嗯采纳,获得10
32秒前
乐乐应助abin采纳,获得10
34秒前
史念薇发布了新的文献求助10
34秒前
34秒前
Hello应助Afaq采纳,获得10
37秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989263
求助须知:如何正确求助?哪些是违规求助? 3531418
关于积分的说明 11253814
捐赠科研通 3270066
什么是DOI,文献DOI怎么找? 1804884
邀请新用户注册赠送积分活动 882084
科研通“疑难数据库(出版商)”最低求助积分说明 809136