消毒薬を使用しない術後創処置の有用性とその経済的効果 [in Japanese] USEFULNESS AND ECONOMIC BENEFITS OF POSTOPERATIVE WOUND TREATMENT WITHOUT ANTISEPTIC SOLUTION [in Japanese]
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目的:消毒液を使用しない創処置方法の導入前後でのSurgical site infection（SSI）の発生と医療材料費について検討し，本処置法の有用性を検証した．方法:2007年4月から2009年3月に手術を施行した315例を対象とした．創の消毒をしていた前半1年（前期）と消毒をしない後半1年（後期）の2群に分け，両群を比較検討した．器械吻合，閉創の縫合方法と皮下洗浄は両群で同様に行った．結果:前期は148症例，後期は167症例．術後SSI発生症例は，全例消化器手術で認め，前期9例（6.1％），後期5例（3.0％）で，発生率に有意差は認めなかった（P=0.185）が，減少傾向を認めた．1例の平均医療材料費は，前期1,370円，後期447円へと67.5％減少した．まとめ:消毒薬を使用しない創処置でも術後SSIの発生は増加せず，消毒薬の使用はSSIの予防に寄与しないことが検証された．本方法は，消毒薬・ガーゼなどのコスト削減と消毒に要する業務軽減に有用である．
(Aim) In this study, we aimed to evaluate the usefulness of postoperative wound treatment without antiseptic solution in terms of the decreased incidence of surgical site infection (SSI) and reduced medical costs after treatment. (Methods) We enrolled 315 patients who had undergone surgery between April 2007 and March 2009. The patients were divided into 2 groups : former patients were treated for 1 year with antiseptic solution (first period) and latter patients were treated for 1 year without antiseptic solution (second period). Wound closure and subcutaneous irrigation methods were the same in both the periods. (Results) There were 148 cases in the first period and 167 in the second period. All SSI occurred in patients who had undergone gastrointestinal operations. There were 9 SSI cases (6.1%) in the first period and 5 (3.0%) in the second period. There was no significant difference between the 2 groups (P = 0.185), but the occurrence of SSI showed a decreasing trend. The average medical material costs per case was 1370 JPY in the first period and 447 JPY in the second period, showing a 67.5 % decrease. (Conclusions) Wound treatment without antiseptic solutions did not increase the incidence of postoperative SSI. Therefore, antiseptic solutions do not contribute to the prevention of SSI. This treatment is useful for cost cutting, as it reduces the use of antiseptic solution and gauze as well as it decreases the workload.
- Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 71(11), 2781-2784, 2010-11-25
Japan Surgical Association