1.Characteristics of SA and MRSA Colonization in Orthopedic Inpatients and their Correlation with Postoperative SSI
Shuliang ZHANG ; Yangdahao CHEN ; Hongfeng SHENG
Journal of Medical Research 2024;53(8):146-149
Objective To investigate the colonization characteristics of staphylococcus aureus(SA)and methicillin-resistant staphylococcus aureus(MRSA)and their correlation with postoperative surgical site infection(SSI)in orthopedic inpatients,and to ana-lyze the related factors affecting their colonization.Methods Nasal swab and pharyngeal swab samples of 420 patients hospitalized in the Department of Orthopedics,Tongde Hospital of Zhejiang Province from January 2020 to October 2022 were collected.Polymerase chain re-action(PCR)was used to detect the positive colonization of SA and MRSA,and clinical data of patients were obtained.x2 test was used to analyze the correlation between SA positive colonization and postoperative SSI.Univariate and multivariate Logistic regression analysis were used to explore the related factors affecting SA colonization.Results Among 420 patients,19 patients were positive for SA,and the overall SA colonization positive rate was 4.5%.17 patients were positive for MRSA,and the overall MRSA colonization positive rate was 4.0%.There was no statistically significant difference in postoperative SSI between SA colonization positive and SA colonization negative patients(P>0.05).Thus,there was no significant correlation between SA colonization and the occurrence of postoperative SSI.Univari-ate Logistic regression analysis showed that age and body mass index(BMI)were influencing factors for SA colonization,while multivari-ate Logistic regression analysis showed that BMI was the risk factor for SA colonization,and the higher the BMI,the higher the colonization risk.Age was the protective factor for SA colonization,and the risk of SA colonization decreased with increasing age.Conclusion SA colonization in orthopedic inpatients does not increase the risk of postoperative SSI,and preoperative SA decolonization that increases the patient's medical cost is unnecessary.BMI is the risk factor for SA colonization in orthopedic inpatients,and age is the protective factor.SA colonization of orthopedic inpatients has regional attributes,and each region needs to make medical plans according to its regional SA colonization epidemiological characteristics.
2.The clinic effect of mini open endoscope assisted-ACDF for cervical spondylotic radiculopathy
Yi WANG ; Bin XU ; Yangdahao CHEN ; Weixing XU ; Hongfeng SHENG
The Journal of Practical Medicine 2024;40(20):2880-2887
Objective Study clinic effect of mini open endoscope assisted-ACDF(MOEA-ACDF)for cervical spondylotic radiculopathy(CSR).Methods From February 2022 to March 2023,CSR patients receiving ACDF in the hospital were included in this study,including conventional ACDF group and MOEA-ACDF group.The preoperative data,operative timeand bone graft fusionwere recorded,VAS score,JOA score,C2-7 Cobb angle and anterior column height of the surgical segment were assessed before and after surgery,and complications were recorded,including wound infection,poor wound healing,hematoma formation,cerebrospinal fluid leakage,nerve injury,and complications related internal fixation.Results There were 41 patients in the conventional ACDF group and 41 patients in the MOEA-ACDF group.Between the two groups,there was no statistically significant difference in preoperative general condition,and there was no statistically significant difference in postoperative VAS pain score,JOA score,C2-7 Cobb angle,and anterior column height.Compared with the conventional ACDF group,the MOEA-ACDF group had a slightly longer surgical time(P=0.02).Compared with pre-operation,the VAS pain scorewas reduced,JOA score,C2-7 Cobb angle,and anterior column height were improved in both groups after operation.There were no postoperative complications such as wound infection,poor wound healing,hematoma formation,cerebrospinal fluid leakage,or nerve damage in both groups.Conclusions The MOEA-ACDF technology for treating CSR can effectively alleviate clinical symptoms,restore cervical spine height and curvature,and achieve clinical effects similar to conventional ACDF surgery,having good effectiveness and safety.Although the operation time of MOEA-ACDF technology is slightly longer than conventional ACDF,it has the advantages of clear and broad surgical field,deep focus,good lighting,less bleeding,and minimal trauma,which makes it con-venient for the operator to perform cervical disc removal,nerve root canal release,posterior longitudinal ligament resection,and reduce nerve,spinal cord,dura mater,and vertebral artery injuries.It is a technology worth pro-moting and applying.