Objective To investigate the impact of comprehensive interventions on the prevention of the incidence of surgical site infection (SSI) after hip or knee arthroplasty.Methods Patients who underwent total hip and knee arthroplasty for the first time in orthopedics department of Chengdu Fifth People’s Hospital from January 2016 to March 2018 were selected. The patients were observed after surgery for 1 year, and divided into the control group and the treatment group according to the odd or even hospitalization number. Basic precautions were taken in the control group, while further comprehensive preventive measures (preoperative chlorhexidine bath, intraoperative body temperature maintenance, using antibacterial film over surgery area without shearing, health and education after discharge from hospital) were taken in the treatment group. The incidence of SSI of the two groups was compared to evaluate the effects of comprehensive interventions.Results A total of 341 patients were included, including 174 in the control group and 167 in the treatment group. No one failed to be followed up. Among the 341 patients undergoing surgery, 13 had SSI, including 11 (6.3%) in the control group and 2 (1.2%) in the treatment group. The incidence of SSI in the treatment group was lower than that in the control group (χ²=6.102, P=0.014). Single factor analysis showed that sex (χ²=10.933, P=0.001), preoperative chlorhexidine sponge bath (χ²=8.837, P=0.003), intraoperative thermal insulation (χ²=13.917, P<0.001), health education (χ²=12.671, P<0.001), skin preparation methods (χ²=6.102, P=0.014), perioperative blood glucose control (χ²=17.512, P=0.003), and surgical type (χ²=8.360,factor P=0.004) were the effect factors of occurrence of SSI. Logistic regression analysis showed that surgical type [odds ratio (OR)=0.129, 95% confidence interval (CI)(0.026, 0.640), P=0.012] and strict blood glucose control [OR=9.868, 95%CI (2.158, 45.131), P=0.003] were the independent factors affecting the occurrence of SSI.Conclusions Comprehensive intervention measures can effectively reduce the occurrence of SSI after hip and knee arthroplasty. It is not confirmed that preoperative chlorhexidine bath can reduce the occurrence of SSI. But choosing selective operation and controlling the perioperative blood glucose below 200 mg/dL can reduce the risk of SSI.

Citation： YANG Jiao, SHI Shuyan, HUANG Qiang. Evaluation of the effect of comprehensive intervention measures on surgical site infection after hip and knee arthroplasty. West China Medical Journal, 2020, 35(3): 307-311. doi: 10.7507/1002-0179.201912136 Copy