Clinical Analysis Of Surgical Site Infection In Department Of Orthopedics

Research purposes: Based on the investigation data of patients in general, we depend to explore the hospital orthopedic treatment process, to find out mainly risk factors in patients with SSI, to control the controllable factors, and to reduce the incidence of SSI as much as possible. We analyzed the case data at the same time, discuss the difference between patients with or without SSI and different types of infection, and try to find out the similarities and differences in the treatment of different types of infection, to summary the standardized treatment of infection.Methods: At the first part, according to the related research results at home and abroad, we summed up the currently recognized mainly risk factors of SSI, sorting and statistical analysis(logistic regression analysis) the general information of patients, to explore the risk factors for SSI in our hospital. And according to the controllable risk factors, we try to set a reasonable controlling project. At the second part, we summed up clinical data of patients with SSI, through statistical analysis(repeated measurements of multi- factor analysis of variance and chi-square test), to find out the similarities and differences in the treatment of different types of infection. We set the temperature, white blood cell count and the C- reactive protein as variables factors. The body temperature is one of the signs that reflecting the body’s inflammatory response, and closely related with the clinical symptoms of patients at the same time, the white blood cell count is the most widely used in the clinical diagnosis of infection, C- reactive protein is a sensitive indicator reflecting the body’s inflammatory response, tending to be the most accurate indicator when the inflammatory response changed. Through the statistical analysis of body temperature, white blood cell count and C- reactive protein, we get a different class of infection patients with clinical characteristics and effective treatment.Results: Patients with diabetes, cerebrovasc ular disease, smoking, long indwelling time of drainage tube and antibiotic using time are the risk factors for SSI, OR(diabetes) = 16.27, OR(cerebrovascular disease) = 5.59, OR(smoking) = 13.13, OR(indwelling time of drainage tube) =1.96, OR(antibiotics) =0.39. The Temperature changing in patients with osteomyelitis and people with shallow and deep infection of incision is statistical significance, white blood cell count in the patients with deep incision infection compared to patients with that in s uperficial infection and osteomyelitis was statistically significant. Temperature changing in patients with acute infection was statistically significant comparing with patients with delayed infection. Comparing with patients with infection caused by staphylococcus aureus, paients with infection caused by coagulase negative staphylococcus, the temperature changing, white blood cell count and C- reactive protein level are all statistically significant. C- reactive protein levels is statistically significant in patients who accept the surgical of removing the artificial implants compared with others.Research conclusions: Diabetes, cerebral vascular disease, smoking, long indwelling time of drainage tube are the risk factors of SSI, and the effect of suffering from diabetes and long-term smoking history is particularly prominent. In the process of diagnosis and treatment of those patients doctors need to pay special attention to the education of strictly controlling of blood glucose, banning on opium smoking and the opium trade, to promote postoperative recovery, and to prevent infection occurrence. Hypertension, heart disease, respiratory system disease are not the risk factors of SSI, but as these factors are combined damage of these diseases are often accompanied by systemic, in the treatment process doctors should pay attention to related diagnosis and treatment. The rational use of antibiotics is good for preventing infection. In addition, reasonable drainage, avoiding excessive blood transfusion and appropriate health education of weight control are trend to promote the health of patients, avoid the occurrence of SSI. Strong virulent bacteria such as Staphylococcus aureus often cause acute infection, spreading to the deep wound, the patient suffer from those bacteria will have obvious temperature increased, leukocyte count and inflammatory mediator levels increased, and doctors tend to suggest patients accept active surgical treatment. Coagulase negative staphylococci is still the main pathogenic bacteria causing SSI in our hospital. The symptoms may be lighter, and the changing of white blood cell count and inflammatory mediators increased level may be lower. But if these bacteria attach to surface of the implants and form biofilm, the bacteria may cause osteomyelitis.