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題名 | 穿孔性闌尾炎傷口即期縫合後導致感染之因素= |
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作者 | 黃永昌; 吳誠中; 黃志仁; 吳天成; 劉自嘉; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 19930900、19931000 |
卷期 | 26:5 民82.09-10 |
頁次 | 頁1989-1995 |
分類號 | 416.243 |
語文 | chi |
關鍵詞 | 穿孔性闌尾炎; 傷口即期縫合; 感染; |
中文摘要 | 急性闌尾炎而接受闌尾切除手術是外科中常見之手術,但闌尾併發穿孔時,術後之致病率則相當高,其中傷口感染為最常見。回顧本院外科過去四年半內,因急性闌尾炎併發穿孔而接受緊急闌尾切除病患共156例,所有傷口皆做即期縫合,其中有61例(39.1%)術後發生傷口感染,發生傷口感染者平均住院日數為20.48天,遠較未發生感染者之7.10天長,若比較傷口感染者與未感染者,我們發現(1)發生症狀至手術時間較長者;(2)術中腹內膿液含量較多者;(3)術中曾對腹膜內膿液加以沖洗者;術後發生傷口感染機會較高,但腹膜縫合後,腹壁肌層及傷口用大量生理食鹽水沖洗卻可減低傷口感染之機會,故我們認為急性闌尾炎併發穿孔,施行闌尾切除役,若傷口要即期縫合,則局部傷口要仔細處理,才可減少傷口之感染機會。至於患者年齡、手術期間長短、傷口的部位、血液常規檢查之結果、術後傷口是否放置引流管等,皆不影響傷口感染之機會。 |
英文摘要 | Appendectomy for acute appendicitis is one of the most common operations. Once the appendix has ruptured, wound infection may be a complication. From January 1985 to June 1990, 156 patients received emergency appendectomies for ruptured appendicitis in this Hospital. All the wounds were primarily sutured. Post-operative wound infection happened in 61 patients, wound infection rate of 39.1 %. The average hospital stay for wound-infected patients was 20.48 days, and for non-infected patients, it was 7.10 days. Risk factors for wound infection are: (1) pre-operative delay; (2) profuse intra-abdominal pus; (3)intra-operative intra-abdominal irrigation; Wound infection rate may be decreased in those patients who received wound irrigation with large amounts of normal saline for the muscular and subcutaneous layers before primary suturing. Patients' ages, operation times, sites of incision, WBC counts and neutrophil ratios, placement of drains made no difference in wound infection rates. |
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