当院[昭和大学附属豊洲病院]におけるSSI発症の原因と対策および効果の検討

概要

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In 1999 CDC guidelines established the concept of SSI. Recently some institutes have reported an SSI incidence rate of less than 5%. The SSI incidence rate in our hospital, however, was reported to be higher than the national average. Because we hypothesized that the main cause of the high incidence rate was intraoperative contamination, we analyzed the transition of enteric bacteria during surgery, enforced techniques to ensure sterile conditions, and reviewed the change of SSI incidence. The transition of enteric bacteria was investigated by administering a pigment (Indigocarmine) to intestional excision sites. By examining the data of pigment distribution during operations, we were able to train the operating room staff in how to prevent contamination: surveillance was performed afterwards. We examined for 863 cases. The incidence of SSI after surveillance was 11.2%, a significant decrease of SSI incidence before surveillance (171%) . This result was most likely due to the increase of the rate of clean-contaminated operations (Class II), and the decrease in the incidence of contaminated operations (Class III) . However, intraoperative contamination and SSI occurrence in Class II still present. Therefore, to prevent SSI more clean operation techniques and an improved consciousness in the operating theater, as in the entire hospital, are needed.
学校法人昭和大学・昭和医学会の論文