neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2020-22-3-51-56neurosurgery-913Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTРезультаты применения протокола профилактики нагноения послеоперационных ран у пациентов с заболеваниями и травмами позвоночникаResults of using the infection avoidance Protocol for postoperative wounds in spinal surgeryГриньА. А.GrinA. A.

129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0001-8547-3322КайковА. К.KaykovA. K.

129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0001-5344-3970КордонскийА. Ю.KordonskiyA. Yu.

Антон Юрьевич Кордонский

129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

akord.neuro@mail.ruhttps://orcid.org/0000-0003-0180-9154КаранадзеВ. А.KaranadzeV. A.

129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0002-4811-0845ЛевинаО. А.LevinaO. A.

129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0003-1974-5785ПопковаЛ. В.PopkovaL. V.

129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. Москвы»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian Federation2020270920202235156Copyright © Гринь А.А., Кайков А.К., Кордонский А.Ю., Каранадзе В.А., Левина О.А., Попкова Л.В., 20202020Гринь А.А., Кайков А.К., Кордонский А.Ю., Каранадзе В.А., Левина О.А., Попкова Л.В.Grin A.A., Kaykov A.K., Kordonskiy A.Y., Karanadze V.A., Levina O.A., Popkova L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/913Введение

Введение. На основании анализа факторов риска нагноения послеоперационной раны был составлен протокол профилактики, предписывающий: не использовать монополярную коагуляцию при манипуляциях на коже и подкожно-жировой клетчатке; удалять гемостатический материал из раны; ослаблять установленный ранорасширитель каждые 65 мин хирургического вмешательства; отказаться от ушивания мышц в области ламинэктомии; отказаться от использования внутрикожного шва.

Цель исследования – верификация протокола профилактики нагноения послеоперационных ран.

Материалы и методы

Материалы и методы. В ходе сплошного ретроспективного когортного исследования были оценены результаты хирургического лечения 575 пациентов с травмами и заболеваниями позвоночника, находившихся под наблюдением в 2014–2016 гг. Пациенты были разделены на группы: оперированные в период с 2014 по 2016 г. (группа сравнения) и оперированные в 2017 г., при лечении которых был применен новый протокол профилактики осложнений (основная группа).

Результаты

Результаты. Доля пациентов с нагноением послеоперационной раны в группе сравнения составила 6 %, а в основной – 1,3 %.

Заключение

Заключение. Рассматриваемый протокол является эффективным средством снижения периоперационных осложнений и может быть рекомендован для профилактики нагноений послеоперационных ран у пациентов с заболеваниями и травмами позвоночника.

Background

Background. We developed a Protocol based on the results of a previous study of risk factors for infection of a postoperative wound: do not use monopolar coagulation on the skin and subcutaneous fat; remove hemostatic material from the wound; relax the established wound expander every 65 minutes; refuse to suture the muscles in the area of laminectomy, refuse to use an intradermal suture.

The study objective is a verification of the received Protocol.

Materials and methods

Materials and methods. A comprehensive retrospective cohort study evaluated the results of surgical treatment of 575 spinal patients who were under the authors’ supervision in 2014–2016. Patients were divided into groups: operated in the period from 2014 to 2016 (control group), operated in 2017, in the treatment of which the Protocol for reducing complications was applied (main group).

Results

Results. It was found that after the introduction of the Protocol, the percentage of patients with postoperative wound infection decreased from 6.0 to 1.3 %.

Conclusion

Conclusion. The resulting Protocol is an effective tool for reducing wound infection and can be recommended for prevention of the postoperative wound infection in patients with spinal with diseases and injuries.

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The authors declare that there are no conflicts of interest present.