全髋关节置换术中手套破损

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背景：骨科手术中发生手套破损的几率可高达26.1%，而手术团队成员在大多数情况下（高达82%）
无法注意到手套穿孔，这无疑增加了伤口污染和血液接触感染传播的风险。

目的：本研究旨在评估全髋关节置换手术团队成员手套破损的频率，确定手术手套破损的性质、部位和危险因素。

材料和方法：本研究分析了154例首次全髋关节置换术（THA）及THA术后翻修过程中外科医生、助手和外科护士使用的1418只手术手套（709副）。

结果：69（44.8%）例手术发生术中手套破损：首次THA术中发生54例（42.2%），THA术后翻修过程中发生15例（57.7%）。在使用的1418只手套中，95只破损（6.7%）；首次THA术中1166只手套里有68只（5.8%）破损，THA术后翻修时252只手套中有27只（10.7%）破损。大多数首次THA和THA术后翻修过程中可见手套穿孔，穿孔率分别为83.6%和85.7%。手套破损大多见于外科医生（45.2%），其次见于助手和手术室护士，分别为41.1%和13.7%。手术破损最为频发的部位为双手食指；左手为40.3%，右手为33.3%。
首次THA时，42.1%的手术手套破损时长长达70分钟，42.3%的手术手套破损时长超过70分钟。THA术后翻修过程中，38.5%的手术手套破损时长长达95分钟，76.9%的手术手套破损时长超过95分钟。

讨论：THA术后翻修过程中，外科医生缝合伤口时最易发生手套破损（87.4%），通常一直不被注意。手套破损的危险因素包括手术持续时间，以及使用缝合针及导丝等锐器。

结论：采用手指非接触性手术技术、定时更换手术手套可降低手套破损风险，从而减少伤口污染和血源性感染传播。

作者简介

Andrei Boyarov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: bojaroffaa@mail.ru
ORCID iD: 0000-0003-0493-7784

MD, PhD, Orthopedic Surgeon, Hip, Knee and Elbow Pathology Department

俄罗斯联邦, Saint Petersburg

Rashid Tikhilov

Vreden Russian Research Institute of Traumatology and Orthopedics; Mechnikov North-Western State Medical University

Email: info@rniito.org
ORCID iD: 0000-0003-0733-2414

MD, PhD, D.Sc., Professor, Director; Professor of Traumatology and Orthopedics Department

俄罗斯联邦, Saint Petersburg

Igor Shubnyakov

Vreden Russian Research Institute of Traumatology and Orthopedics, Saint-Petersburg, Russia

Email: info@rniito.org
ORCID iD: 0000-0003-0218-3106

MD, PhD, D.Sc., Chief Researcher

俄罗斯联邦, Saint Petersburg

Ali Midaev

Vreden Russian Research Institute of Traumatology and Orthopedics

编辑信件的主要联系方式.
Email: Midaewali@gmail.com
ORCID iD: 0000-0003-1998-0400

MD, Clinical Resident

俄罗斯联邦, Saint Petersburg

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