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首页> 外文期刊>Emergency medicine journal: EMJ >Traumatic lacerations: What are the risks for infection and has the 'golden period' of laceration care disappeared?
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Traumatic lacerations: What are the risks for infection and has the 'golden period' of laceration care disappeared?

机译：创伤性撕裂伤：感染的风险是什么？撕裂伤护理的“黄金时期”消失了吗？

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Objective: To determine risk factors associated with infection and traumatic lacerations and to see if a relationship exists between infection and time to wound closure after injury. Methods: Consecutive patients presenting with traumatic lacerations at three diverse emergency departments were prospectively enrolled and 27 variables were collected at the time of treatment. Patients were followed for 30 days to determine the development of a wound infection and desire for scar revision. Results: 2663 patients completed follow-up and 69 (2.6%, 95% CI 2.0% to 3.3%) developed infection. Infected wounds were more likely to receive a worse cosmetic rating and more likely to be considered for scar revision (RR 2.6, 95% CI 1.7 to 3.9). People with diabetes (RR 2.70, 95% CI 1.1 to 6.5), lower extremity lacerations (RR 4.1, 95% CI 2.5 to 6.8), contaminated lacerations (RR 2.0, 95% CI 1.2 to 3.4) and lacerations greater than 5 cm (RR 2.9, 95% CI 1.6 to 5.2) were more likely to develop an infection. There were no differences in the infection rates for lacerations closed before 3% (95% CI 2.3% to 3.8%) or after 1.2% (95% CI 0.03% to 6.4%) 12 h. Conclusions: Diabetes, wound contamination, length greater than 5 cm and location on the lower extremity are important risk factors for wound infection. Time from injury to wound closure is not as important as previously thought. Improvements in irrigation and decontamination over the past 30 years may have led to this change in outcome.
机译：目的：确定与感染和创伤性撕裂相关的危险因素，并查看感染与受伤后伤口闭合时间之间是否存在关系。方法：前瞻性招募了三个不同急诊科连续出现创伤性撕裂伤的患者，并在治疗时收集了27个变量。随访患者30天，以确定伤口感染的发展以及是否需要修复疤痕。结果：2663例患者完成了随访，其中69例（2.6％，95％CI 2.0％至3.3％）发生了感染。感染的伤口更有可能获得较差的美容等级，并且更可能考虑进行疤痕修复（RR 2.6，95％CI 1.7至3.9）。糖尿病患者（RR 2.70，95％CI 1.1至6.5），下肢撕裂伤（RR 4.1，95％CI 2.5至6.8），污染的撕裂伤（RR 2.0，95％CI 1.2至3.4）和大于5 cm的撕裂伤（ RR 2.9、95％CI 1.6至5.2）更容易发生感染。 12小时之前3％（95％CI 2.3％至3.8％）或1.2％（95％CI 0.03％至6.4％）12小时之前闭合的撕裂伤的感染率没有差异。结论：糖尿病，伤口污染，长度超过5 cm和下肢位置是伤口感染的重要危险因素。从受伤到伤口闭合的时间并不像以前想象的那么重要。过去30年中灌溉和净化的改善可能导致了结果的变化。

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