Objective To explore the efficacy of circular wound edge protector(CWEP)in preventing surgical site infection (SSI)following open abdominal surgery,analyze the related risk factors for postoperative SSI,and provide scientific basis for preventing SSI following open abdominal surgery.Methods 162 patients who underwent open abdominal surgery in a hospital from March 2014 to December 2015 were randomly divided into intervention group (used CWEP during surgery)and control group (used sterile gauze pad to protect incision).Length of hospital stay,cost of dressing change,and SSI between two groups were compared,risk factors for postoperative SSI were analyzed.Results Incidence of SSI in intervention group was lower than control group (14.81%[12/81]vs 34.57%[28/81],P <0.05);grade-A incision healing rate of intervention group was higher than control group(86.42% vs 66.67%,P <0.05).The cost of dressing change in intervention group was lower than control group([305.5 ± 176.7]yuan vs [431.6 ± 381.4 ]yuan,P = 0.008 ). Multivariate logistic regression analysis indicated that hypoproteinemia(OR,2.88[95%CI ,1.21-6.87]),body mass index ≥24(OR,3.11[95%CI ,1.12-8.66]),and blood loss≥400 mL(OR,3.98[95%CI ,1.36- 11.64])were independent risk factors for postoperative SSI,while CWEP use was the protective factor(OR,0.24[95%CI ,0.09-0.59]).Conclusion CWEP can effectively reduce the incidence of SSI following open abdominal surgery.

Objective To provide anatomical landmarks with which to facilitate flap dissection,we studied the perforator artery of the dorsal forearm including its source,quantity,origination,caliber,variation and pedicle length. Methods Ten fresh cadavers were injected with a modified lead oxide-gelatin mixture,and three-dimensional graphics of the perforator vessels of the dorsal forearm were reconstructed with a computed tomography. In addition, twenty upper extremity specimens were injected with red latex via the axillary artery.The integument of the forearm was dissected,and perforators were identified,including type,course,size and location were documented.Surface areas were measured with Scion Image. Results The average number of the posterior interosseous artery cutaneous perforators in the dorsal forearm was (5±2),the average outer diameter of the perforator artories was (0.5 ± 0.1) mm,and the pedicle length was (2.5 ±0.2) cm.The average cutaneous vascular territory was (22.0 ± 15.0) cm2.The dorsal branch of the anterior interosseous artery dispersed on the wrist dorsum or the distal third of the dorsal forearm. It's average diameter was 0.8 mum. Conclusion The free transplantation of the posterior interosseous perforator artery flaps or rotary flap pedicled by the dorsal branch of the anterior interosseous artery for defect reconstruction are feasible.