Objective To investigate the occurrence and susceptibility factors of surgical site infection(SSI) in patients undergoing oral-maxillo facial surgery with micro vase alar free-flap reconstruction. Methods From December 2010 to September 2011, a prospective survey was performed to monitor the susceptibility factors for SSf in 257 patients undergoing oral-maxillofacial surgery with microvascular free-flap reconstruction, the surveyed contents included age, sex, the nature of disease, American Society of Anestheesiologists(ASA) score, white blood cell, he-ma toglobin, length of hospital stay, length of surgery, types of incision, intraoperative blood loss and so on. Patients were followed up alter 1, 3 and 6 months of operation, the occurrence of SSI at different stages were surveyed. Results Of 257 patients, 46 (17. 90%) developed SSf, and all were deep wound infection, 19 (41. 30%) of whom had SSf during hospitalization period, and 27 (58. 70%) were found through post-discharge follow-up investigation. Infection occurred 5 - 34 days after operation, the median time was 11 day. Monitoring of susceptibility factors showed that,except the duration of intraoperative antimicrobial use (≤110 min) was statislically significant (P ＜0. 05), other factors were not statistically significant (P＞0. 05). Conclusion Incidence of SSI is high in oral-maxillofacial surgery with microvascular free-flap reconstruction, and mostly occur in patients after discharging from hospital. In order to reduce SSI effectively, clinical attention should be paid, postoperative follow-up should be intensified, intervention in susceptibility factors should be performed, and antimicrobial agents should be used rationally.%目的 了解口腔颌面部游离组织皮瓣手术手术部位感染(SSI)发生情况及其易感因素.方法 采用前瞻性调查方法对2010年12月-2011年9月在某院接受口腔颌面部游离组织皮瓣移植修复术的257例患者进行SSI易感因素监测,项目包括年龄、性别、疾病性质、ASA评分、白细胞计数、血红蛋白值、住院天数、手术持续时间、切口类型、术中出血量等.分别在术后1、3、6个月随访3次,跟踪调查不同时段SSI发生情况.结果 257例患者发生SSI 46例(17.90%),均为深部切口感染;其中19例(41.30%)感染发生在住院期间,27例(58.70%)为出院后随访发现的感染,供区未发生感染.感染发生时间为术后5～34 d,中位数为11 d.易感因素监测中除骨组织皮瓣手术术中抗菌药物给药时间(术中≤110 min给药)有统计学意义(P＜0.05),其他因素均无统计学意义(P＞0.05).结论 口腔颌面部游离组织皮瓣手术SSI发生率较高,且较多发生在出院后,临床应重视,加强术后随访;同时针对易感因素进行干预,合理使用抗菌药物,有效降低SSI的发生.
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