The Epidemiological Survey And Correlation Factor Analysis Of Postoperative Infection In Traumatology

Objective:To clarify the influencing factors of postoperative infection in traumatology and its correlation with the constitution of traditional Chinese medicine,and to provide the clinical theoretical basis for the early diagnosis and prevention of postoperative infection in traumatology.Method:The self-designed clinical case questionnaire,the questionnaire of classification and determination of constitution of traditional Chinese Medicine issued by the Chinese society of traditional Chinese medicine and the way of consulting the electronic case system(HISS system)of our hospital were used to carry out the investigation.The patients who met the inclusion criteria were investigated from the distribution of pathogenic bacteria,the influencing factors of perioperative period,laboratory examination and the constitution of traditional Chinese medicine.Single factor and logistic regression were used to analyze the data.Results:1.In this study,a total of 1000 patients were included,37 patients had postoperative infection,the infection rate was 3.70%;a total of 46 strains of pathogenic bacteria were isolated,mainly Gram-positive bacteria,accounting for 58.70%of the total distribution of pathogenic bacteria,Gram-positive bacteria were mainly Staphylococcus aureus and Staphylococcus epidermidis,and Gram-negative bacteria were mainly Escherichia coli and Pseudomonas aeruginosa.2.There was no significant relationship between postoperative infection and gender,drinking,cause of injury,education level of patients,ASA classification,different fracture sites,title of chief surgeon,skin staplers,incision length,postoperative use of ventilator and constitution type of traditional Chinese medicine(P>0.05).Infection and age,smoking,body mass index,open fracture,combined basic diseases(diabetes,hypertension,hyperlipidemia),ICU treatment before operation,different operation seasons,emergency operation,general anesthesia,invasive operation,intraoperative blood loss,incision type,operation duration,ICU treatment after operation,dead cavity left by wound,negative pressure drainage,blood transfusion The rational use of antibiotics in perioperative period and the number of days in hospital were significantly related,the difference was statistically significant(P<0.05).Age(?60years old),obesity(BMI?28Kg/m~2),diabetes mellitus,type III incision,operation duration,intraoperative bleeding volume,negative pressure drainage,rational use of antibiotics in perioperative period,and hospital stay were all independent factors of postoperative infection in orthopaedic trauma,the difference was statistically significant(P<0.05).3.The postoperative infection rates of different fracture sites were 5.23%of tibia and fibula,2.83%of femur,3.74%of calcaneus,1.90%of radius and ulna,and 1.71%of humerus.The infection rates in different seasons were 1.81%in spring,6.35%in summer,3.52%in autumn and 1.92%in winter.4.There were significant differences in early postoperative C-reactive protein,ESR,hemoglobin and albumin between the patients with postoperative infection and those without postoperative infection(P<0.05).5.The distribution of constitution in traditional Chinese medicine:297 cases were of peaceful quality,accounting for 29.70%,and 70.30%of biased quality.The top four biased quality:Yang deficiency quality(15.40%),Qi deficiency quality(14.90%),yin deficiency quality(12.60%),phlegm dampness quality(11.90%).Conclusions:1.In this study,Gram-positive bacteria were the main pathogens,Staphylococcus aureus and Staphylococcus epidermidis were the main Gram-positive bacteria,Escherichia coli and Pseudomonas aeruginosa were the main Gram-negative bacteria.2.Old age(?60years old),obesity,smoking,combined with basic diseases(diabetes,hypertension,hyperlipidemia),open fracture,preoperative access to ICU treatment,general anesthesia,emergency surgery,invasive operation,intraoperative blood loss,class III surgical incision,operation duration,wound left dead cavity,blood transfusion,hospitalization days are all risk factors of postoperative infection in orthopaedic trauma.Elderly(?60years old),obesity,diabetes mellitus,duration of operation and intraoperative blood loss were independent risk factors of postoperative infection.Rational use of antibiotics and negative pressure drainage are the protective factors of postoperative infection.3.The infection rate of lower limb fracture(tibiofibula,femur,calcaneus)is higher than that of upper limb fracture(humerus,radius),and the infection rate of tibiofibula fracture is the highest.The infection rate in summer was higher than that in other seasons.4.Dynamic monitoring of WBC,ESR,CRP,PCT and other related laboratory tests is conducive to early detection and diagnosis of postoperative infection in trauma orthopedics.5.In this study,there is no obvious correlation between the constitution of traditional Chinese medicine and the postoperative infection of orthopaedic trauma;the top five constitution are the quality of peace,the quality of Yang deficiency,the quality of qi deficiency,the quality of yin deficiency and the quality of phlegm dampness.