关键词: 骨科, 清洁手术, 清洁切口, 皮肤准备, 目标性监测, 手术部位感染, 危险因素

Abstract: Objective To analyze the risk factors for surgical site infection (SSI) in clean wound orthopedics surgery, and to explore how to control it. . Methods SSI among patients receiving clean wound orthopedic surgery from June 2015 to December 2016 were monitored, Chi-square test was used to analyze the related influencing factors(age, ASA score, skin preparation modes, operation time, types of surgery , use of Antibacterials, drainage tube indwelling) of postoperative infection in clean wound orthopedics surgery, multiple Logistic regressions were used to analyze the positive risk factors. Results A total of 792 patients were monitored, 17 cases (2.15%) of SSI occurred. The results of chi-square test showed that elder age，ASA score ≥ grade Ⅱ,conventional skin preparation, long operation time, complicated operation type , irrational use of antibiotics might increase the risk of clean wound orthopedic surgical infection (all P values <0.05)，but patients’ gender, the surgeons’ level and operation skill , drainage tube indwelling did not. Multiple Logistic regressions results showed that ASA score ≥ grade Ⅱ,conventional skin preparation and long operation time might increase the risk the clean wound orthopedic surgical infection，and the highest risk factors was long operation time(＞3h), and then ASA score ≥ grade Ⅱ and conventional skin preparation. [OR (95%CI), 4.08(1.36-12.35),3.46(1.98-21.12),2.97 (1.08-14.71)]. Conclusion Elder age，ASA score ≥ grade Ⅱ and conventional skin preparation may increase the risk of clean wound orthopedic surgical infection. Medical staff should be fully aware of these risk factors, optimize the regulatory factors most in perioperative period and maximally reduce the incidence for SSI in clean wound orthopedics surgery.

Key words: orthopedics, clean operation, clean wound, skin preparation, targeted monitoring, surgical site infection, Risk factors