Ⅰ类切口手术部位感染术后不同监测时长感染监测效果评价OA

Objective To establish a post-discharge follow-up surveillance scheme for surgical site infection(SSI)after class I incisional surgery,determine the optimal follow-up duration,and provide evidence-based support for implementing effective post-discharge SSI surveillance.Methods A prospective targeted surveillance was conducted in a tertiary first-class hospital in Beijing City in 2021,SSI was surveilled through inpatient surveillance combined with post-discharge text-message and telephone follow-up,and the incidence of SSI was compared between inpatient surveillance alone and inpatient surveillance combined with post-discharge follow-up surveillance.Based on the 1-year postoperative surveillance results,incidence rates of SSI of the 90-day and 30-day of postoperative surveillance periods were analyzed.Results A total of 34 294 patients undergoing class I incisional surgery were included in the analysis,with orthopedic patients accounting for 87.95%.When only performing inpatient surveillance,the incidence rate of SSI of class I incisional surgery was 0.06%.After combining with post-discharge follow-up surveillance,SSI incidence rate calculated by taking all surveilled objects as the denominator was 0.24%,with a statistically significant difference between the two(χ2=62.02,P<0.001).Among the 84 infected cases,13 cases(15.48%)of SSI occurred during hospitalization,and 71 cases(84.52%)occurred after discharge.The median time for SSI occurrence was 21 days after surgery.Among the 71 patients who developed SSI after discharge,the median time from discharge to SSI occurrence was 16 days.When the surveillance time for surgical patients after discharge shortened from 1 year to 90 days after surgery,3 cases(3.57%)of SSI would be missed;if shortened to 30 days,16 cases(19.05%)would be missed.Post-discharge follow-up surveillance showed that there was no statistically significant difference in SSI incidence between 90-day and 1-year after surgery(χ2=1.33,P=0.248).Conclusion It is recommended to shorten SSI surveillance duration for specific surgeries or implant-related surgeries to 90 days after surgery,or develop a stratified surveillance strategy,so as to make SSI surveillance more scientific and efficient and to provide reference and basis for evaluating SSI prevention and control measures.