Analysis of problems in skin management for elderly patients undergoing orthopedic major surgery and factors affecting incision infection
老年患者骨科大手术皮肤管理中存在的问题及对切口感染的影响因素分析

摘要

目的 分析老年患者骨科大手术皮肤管理中存在的问题及对切口感染的影响因素。方法 回顾性分析本院在2025年1月-2026年1月期间收治的100例老年骨科大手术患者临床资料。收集患者一般信息、皮肤管理相关情况及术后切口感染发生情况，对皮肤管理中存在的主要问题予以梳理，采取单因素分析及多因素Logistic回归分析筛选切口感染的独立影响因素。结果 100例老年骨科大手术患者术后发生切口感染率为6.00%。皮肤管理中主要存在术前皮肤准备不规范、术中皮肤保护不足、术后皮肤护理不到位及患者及家属配合度差问题。单因素分析可见，年龄≥75岁、合并糖尿病、术前皮肤准备不规范、术中皮肤受压损伤、术后切口渗液处理不及时及营养不良为切口感染相关因素（P＜0.05）；多因素Logistic回归分析可见，合并糖尿病、术前皮肤准备不规范、术后切口渗液处理不及时及营养不良为切口感染的独立危险因素（P＜0.05）。结论 老年患者骨科大手术皮肤管理中存在较多方面的问题，合并糖尿病、术前皮肤准备不规范、术后切口渗液处理不及时及营养不良可明显提高切口感染风险，临床应针对性优化皮肤管理措施，加强各环节护理质量，减少切口感染的发生率。

Abstract

Objective To analyze the problems in skin management for elderly patients undergoing orthopedic major surgeries and the influencing factors of incision infection.
Methods The clinical data of 100 elderly patients undergoing orthopedic major surgeries in our hospital from January 2025 to January 2026 were retrospectively analyzed. General information of patients, skin management conditions, and the occurrence of incision infection after surgery were collected. The main problems in skin management were sorted out, and single-factor analysis and multivariate Logistic regression analysis were adopted to screen the independent influencing factors of incision infection.
Results The incision infection rate of 100 elderly patients undergoing orthopedic major surgeries was 6.00%. The main problems in skin management included improper preoperative skin preparation, insufficient skin protection during surgery, inadequate postoperative skin care, and poor cooperation of patients and their families. Single-factor analysis showed that age ≥ 75 years old, diabetes, improper preoperative skin preparation, postoperative skin pressure injury, untimely handling of incision exudate, and malnutrition were related factors of incision infection (P < 0.05); multivariate Logistic regression analysis showed that diabetes, improper preoperative skin preparation, untimely handling of incision exudate after surgery, and malnutrition were independent risk factors for incision infection (P < 0.05).
Conclusion   There are many problems in skin management for elderly patients undergoing orthopedic major surgeries. Diabetes, improper preoperative skin preparation, untimely handling of incision exudate after surgery, and malnutrition can significantly increase the risk of incision infection. Clinically, targeted optimization of skin management measures and strengthening of each link of nursing quality should be carried out to reduce the incidence of incision infection.