为耳内入路耳科手术患者做好消毒和卫生准备

W. H. Suaifan, K. Eremeeva, S. V. Morozova
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摘要

简介。优化耳科手术的术前准备方案可减少术中和术后感染并发症,改善手术效果,这对耳病患者的康复非常重要。目的:确定耳内手术干预期间手术野防腐和卫生术前准备的有效性。随机研究包括 183 名通过耳内法接受手术的患者。研究的第一部分评估了 10%聚维酮碘溶液治疗对皮肤微生物群的影响;第二部分评估了耳道脱毛的必要性和手术前的准备情况,并对两种方法进行了比较。85%的外耳道皮肤微生物群检查显示有微生物生长:葡萄球菌--115(85.5%)、真菌生长--6(4.4%)、棒状杆菌--8(5.9%)等。15%的病例未检测到微生物生长。使用 10%聚维酮碘溶液对硬膜内入路进行消毒处理,可降低污染程度,抑制三分之一以上患者的微生物生长。术后伤口的炎症变化与对照组和研究组的炎症IA程度一致。脱毛后,100% 的病例可视度均达到最佳,且未发现炎症反应。使用剪刀的平均脱毛时间为 113 秒,使用修耳器的平均脱毛时间为 32 秒。术前消毒准备可减少经耳内入路皮肤的微生物污染,对术后伤口愈合过程无明显影响。100%的病例都通过脱毛改善了手术视野。使用耳廓修剪器进行脱毛比使用剪刀快 3.5 倍。
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Antiseptic and hygienic preparation of patients for ear surgery with an endaural approach
Introduction. Optimization of preoperative preparation protocols in otosurgery can reduce intraand postoperative infectious complications, improve surgical outcomes, which is important for the rehabilitation of patients with ear diseases.Aim. To determine the effectiveness of antiseptic and hygienic preoperative preparation of the surgical field during endaural otosurgical interventions.Materials and methods. The randomized study included 183 patients who underwent surgery via the endaural approach. The first part of the study evaluated the effect of 10% povidone-iodine solution treatment on the skin microbiome; the second part evaluated the need for ear canal depilation and before surgery and compared the methods.Results. Examination of skin microbiota of the external auditory canal in 85% revealed the growth of microorganisms:Staphylococcus – 115 (85.5%), fungal growth – 6 (4.4%), Corynebacterium – 8 (5.9%), etc. Microbial growth was not detected in 15%. Antiseptic treatment with 10% Povidone-iodine solution with endaural access reduces the degree of contamination and suppresses the growth of microorganisms in more than one third of patients. Inflammatory changes of the postoperative wound correspond to the degree of inflammation IA in both control and study groups. After depilation, visualization was assessed as optimal in 100% of cases and no inflammatory reactions were found. Average depilation time with scissors 113 sec, with an ear trimmer 32 sec.Conclusions. Preoperative antiseptic preparation reduces microbial contamination of the skin via endaural access, with no significant impact on wound healing process in the postoperative period. Depilation improved the view of the operative field in 100% of cases. Depilation with an ear trimmer is 3.5 times faster than with scissors.
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