洁净层流手术间开放性脊柱手术中无菌灯柄细菌检出情况及危险因素分析OACSTPCD

Objective To investigate the bacterial contamination status and risk factors of sterile lamp handle used during open spinal surgery in clean laminar flow operating room at different time periods,so as to provide basis for timely replacement of lamp handle and implementation of intervention measures.Methods A total of 275 sterile lamp handles used during open spinal surgery in clean laminar flow operating room were selected as the research objects,and the outer surface of the lamp handle was sampled with sterile cotton swab,and the bacteria detection and risk factors of the lamp handle at different time periods were analyzed.Results Among 275 sterile lamp handles used during open spinal surgery,41(14.91%)lamp handles detected bacteria from 3 hours after operation;and 53 strains of bacteria were cultured,among which 17 strains(32.08%)were Escherichia coli,accounting for the highest proportion.Univariate and multivariate Logistic regression analysis showed that complicated open trauma,operation time≥5 hours,intraoperative blood loss≥400 mL,intraoperative use of sterile lamp handle against the lamp≥10 times,obvious blood contamination of lamp handle and number of operating room personnel≥8 were the risk factors leading to the detection of bacteria in lamp handle(OR>1,P<0.05).Conclusion The bacterial contamination of sterile lamp handle used during open spinal surgery in clean laminar flow operating room is mainly caused by Escherichia coli.The bacterial contamination of the lamp handle is related to open trauma,operation time,amount of blood loss,number of sterile lamp handle used against the lamp,obvious blood contamination of lamp handle and number of operating room personnel,etc.It is suggested that the lamp handle should be replaced when the operation time is longer than 3 hours.