ObjectiveTo investigate the disinfection effect of dry-fogging hydrogen peroxide (DFHP) on ambulance inner surfaces.MethodsThis study was carried out using simulated field test and field test from October to December 2018. In the simulated field test, the carriers with Geobacillus stearothemopilus (ATCC12980) spores were placed in 6 places in the ambulance, and disinfected for 60 minutes with DFHP of 0.38–0.72 g/m3. The carriers were cultured for up to 7 days to observe whether the bacteria were eliminated. Before and after the DFHP disinfection, the microbial sampling of the surface in the ambulance was carried out, and the colonies were counted after the cultivation.ResultsThe eliminating rate of the bacteria carriers on the uncovered surface was 100% (20/20), and that of the covered surface was 10% (1/10). The pass rate of microbial sampling was 100% (26/26).ConclusionsThe DFHP had a significant decontamination effect on the ambulance inner uncovered surfaces. The DFHP equipment is automated and their disinfecting quality is consistent, therefore it is suitable for the disinfection of ambulance inner surfaces. But the limitation of disinfection effect on covered surfaces should be avoided.
Objective To investigate the application of risk assessment in the control of nosocomial infections in surgical departments of infectious disease hospitals so as to provide references for the regulation of prevention and control measures. Methods Nosocomial infection risks in surgical departments of infectious disease hospitals were identified by the method of brainstorming. Based on risk assessment and planning of American children's national medical center in Washington for epidemic and infectious diseases control, the matrix method was used for risk assessment. The three highest risks were controlled, and then we compared the incidence of nosocomial infections before and after the risk assessment. Results The major risk factors in surgical departments existed in the process of diagnosis and treatment. By matrix scoring, excluding high readiness items, we found that the top three risks were airborne diseases, prevention and nursing of hematogenous infections and air disinfection. Nosocomial infection rate in the surgical departments dropped to 2.03% after carrying out risk assessment and taking correspondent measures (χ2=5.480,P=0.019). Conclusion Evaluation of nosocomial infection risk in surgical departments of infectious disease hospitals can discover major potential risks and reduce the incidence of nosocomial infections, which can provide references for management and control of nosocomial infections.
ObjectiveTo measure and evaluate the economic burden of hospital infection in Sichuan, and provide a basis for targeted economic evaluation of healthcare-associated infection (HAI).MethodsIn hospitals participating in the 2016 Sichuan provincial prevalence survey of HAI, matched cases were used to extract cases and controls, and then a multi-center nested case-control study was conducted.ResultsA total of 225 pairs/450 patients were selected in 51 hospitals, and 175 pairs/350 patients were successfully matched. The median of the difference of hospitalization costs between matched-pairs were RMB 3 362.0, and the difference was statistically significant (Z=3.275, P<0.001).ConclusionsThe hospitalization costs caused by HAI should be given special attention in the current medical insurance reform. Efforts need to be taken to reduce the hospitalization costs caused by HAI.
Objective To explore the effectiveness of free paraumbilical perforator flaps in repairing skin and soft tissue defects in children. Methods Between February 2018 and March 2024, 12 children with skin and soft tissue defects were treated with the free paraumbilical perforator flaps. There were 7 boys and 5 girls with an average age of 6.3 years (range, 2-12 years). The defects located on the upper limbs in 6 cases, lower limbs in 5 cases, and neck in 1 case. The causes of wounds included 7 cases of electrical burns, 1 case of thermal burn, 2 cases of scar release and excision due to scar contraction after burns, 1 case of scar ulcer at the amputation stump after severe burns, and 1 case of skin necrosis after a traffic accident injury. The size of defects after debridement ranged from 7.0 cm×4.0 cm to 18.0 cm×10.0 cm. According to the defect size, 11 cases were repaired with unilateral paraumbilical perforator flaps centered on the umbilicus, among which 3 cases with larger defects were designed as “L”-shaped flaps along the lateral and lower ends of the perforator; the donor sites were directly closed. One case with extensive defect after scar excision and release was repaired with bilateral expanded paraumbilical perforator flaps; the donor sites were repaired with autologous split-thickness skin grafts. The size of flaps ranged from 9.0 cm×4.0 cm to 20.0 cm×11.0 cm. Postoperatively, analgesia and sedation were provided, and the blood supply of the flaps was observed. Results All operations were successfully completed. The operation time was 4-7 hours, with an average of 5.0 hours. After postoperative analgesia and sedation, the visual analogue scale (VAS) score for pain in all children was less than or equal to 3, and there was no non-cooperation due to pain. All flaps and skin grafts survived completely, and the wounds healed by first intention. Ten children underwent 1-4 times of flap de-fatting, finger separation, and trimming. All children were followed up 6-48 months (mean, 26.6 months). No obvious swelling of the flaps occurred, and the texture was soft. At last follow-up, among the 6 children with upper limb defects, 2 had upper limb function grade Ⅳ and 4 had upper limb function grade Ⅴ according to the Carroll upper limb function assessment method. The 4 children with lower limb defects had no limitation of joint movement. The neck flexion and rotation in the 1 child with neck defect significantly improved when compared with that before operation. The 1 child with residual ulcer at the amputation stump could wear a prosthesis and move without limitation, and no new ulcer occurred. Linear scars were left at the donor sites, and no abdominal wall hernia was formed. ConclusionThe free paraumbilical perforator flap has abundant blood supply and can be harvested in large size. It can be used to repair skin and soft tissue defects in children and has the advantages of short operation time, minimal injury, high safety, and minimal impact on the growth and development of children.