PLOS ONE:非常严重肥胖的剖宫产手术部位皮肤感染的预测因子和临床结果:回顾性队列研究

2019-06-30 海北 MedSci原创

对于肥胖非常严重(体重指数(BMI)> 40kg / m2)的女性,剖宫产的最佳手术方法尚不确定

对于肥胖非常严重(体重指数(BMI> 40kg / m2)的女性,剖宫产的最佳手术方法尚不确定。

最近进行的一项研究的目的是评估非常严重肥胖妇女手术部位皮肤感染SSSI)的母亲和外科预测因素,并对腹膜下横向皮肤切口与超横丘膜切口的女性的临床结果进行探索性评估。

研究人员使用回顾性队列设计,对20118月至201512月(n = 453)在苏格兰两家妇产医院进行剖腹产的非常严重肥胖妇女的病例进行了审查。 

Logistic回归分析用于确定SSSI的预测因子。研究人员比较了具有超横丘膜横切皮肤切口的女性与下肢横切皮肤切口的女性的结果。

结果显示,较低的母亲年龄可预测SSSI,目前的吸烟状况和较长的伤口开放时间具有轻微的显着性。母体BMI,缝合方法和材料显示出与SSSI的单变量关联,但不是独立预测因子。腹膜上横切口的妇女年龄较大(32.94.4),vs 30.65.7),p = 0.002),BMI较高(49.27.1),vs 43.33.3),p <0.001),分娩时间较短(天数)(267.714.9),vs 274.814.5),p <0.001),妊娠期糖尿病患病率较高(42.6vs21.9%,p = 0.002)。 SSSI率在横纹上皮(13/47; 27.7%)和横纹(90/406; 22.2; p = 0.395)皮肤切口之间没有差异。

因此,无论皮肤切口位置如何,剖腹产后非常严重的肥胖女性的SSSI率都很高。


原始出处:

Dias M et al. Predictors of surgical site skin infection and clinical outcome at caesarean section in the very severely obese: A retrospective cohort study. PLOS ONE, 2019; doi: 10.1371/journal.pone.0216157. eCollection 2019.


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