Study design

Retrospective matched case-control study including patients with spinal cord injury who presented with an anus-near pressure injury. Two groups were formed based on the presence of a diverting stoma.

Objectives

To evaluate the primary microbial colonisation and secondary infection of anus-near pressure injuries depending on the presence of a pre-existing diverting stoma and to investigate the effect on the wound healing.

Setting

University hospital with a spinal cord injury unit.

Methods

A total of 120 patients who had undergone surgery of an anus-near decubitus stage 3 or 4 were included in a matched-pair cohort study. Matching was realised according to age, gender, body mass index and general condition.

Results

The most common species in both groups was Staphylococcus spp.(45.0%). The only significantly different primary colonisation affected Escherichia coli, that was found in the stoma patients less often (18.3 and 43.3%, p < 0.01). A secondary microbial colonisation occurred in 15.8% and was equally distributed, except for Enterococcus spp. that was present in the stoma group only (6.7%, p < 0.05). The time to complete cure took longer in the stoma group (78.5 versus 57.0 days, p < 0.05) and was associated with a larger ulcer size (25 versus 16 cm², p < 0.01). After correction for the ulcers’ size, there was no association to outcome parameters such as overall success, healing time or adverse events.

Conclusions

The presence of a diverting stoma alters the microbial flora of an anus-near decubitus slightly without impact on the healing process.

中文翻译：

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粪便改道后的微小微生物变化不会影响脊髓损伤患者肛门附近压力损伤的愈合过程 - 匹配病例对照研究的结果

学习规划

回顾性匹配病例对照研究，包括出现肛门附近压力损伤的脊髓损伤患者。根据分流造口的存在形成两组。

目标

根据预先存在的分流造口的存在来评估肛门附近压力损伤的原发性微生物定植和继发性感染，并研究对伤口愈合的影响。

环境

大学医院设有脊髓损伤科。

方法

一项配对队列研究纳入了总共 120 名接受过 3 期或 4 期肛门近褥疮手术的患者。根据年龄、性别、体重指数和一般情况实现匹配。

结果

两组中最常见的菌种是葡萄球菌属（45.0%）。唯一显着不同的原代定植影响大肠杆菌，在造口患者中较少发现（18.3% 和 43.3%，p  < 0.01）。除肠球菌属外，二次微生物定植发生率为 15.8%，且分布均匀。仅存在于造口组中（6.7%，p  < 0.05）。造口组完全治愈的时间更长（78.5 天与 57.0 天，p  < 0.05），并且与较大的溃疡尺寸相关（25 vs 16 cm ²，p  < 0.01）。校正溃疡大小后，与总体成功率、愈合时间或不良事件等结果参数没有关联。

结论

分流造口的存在会轻微改变肛门附近褥疮的微生物菌群，但不会影响愈合过程。