Background: A Care Bundle is proposed to prevent surgical site infections (SSIs). This study investigated SSI incidence and risk factors at our hospital, developed an SSI prevention Care Bundle, and tested its efficacy. Methods: A retrospective review of 1,117 patients who underwent spinal surgical procedure under general anesthesia (January 2016-July 2023) was conducted. A total of 764 patients (mean age 69.7 y, 58.0% female) were included. SSI was diagnosed as per U.S. Centers for Disease Control and Prevention's guidelines. Risk factors evaluated included patient factors, operation-related factors, season, and Care Bundle implementation (introduced in April 2019). The Care Bundle included chlorhexidine gluconate bathing, skin disinfection, high-performance air purifier, glove changes, iodine-impregnated drapes, prophylactic antibiotic agents, and pre-operative sponge brushing. Results: SSI incidence was 2.6% (0.7% superficial, 1.9% deep), decreasing from 4.6% pre-Care Bundle to 1.0% post-implementation. Risk factors included smoking (p = 0.003), diabetes mellitus (p = 0.025), instrumentation (p = 0.039), posterior cervical operation (p = 0.049), and warm season (p = 0.024). Logistic regression identified Care Bundle implementation (odds ratio [OR] 0.27, p = 0.013), instrumentation (OR 3.59, p = 0.038), and warm season (OR 3.63, p = 0.025) as independent factors. Conclusion: The Care Bundle effectively reduced SSI. Certain factors such as instrumentation and surgical procedures during warm seasons were associated with greater SSI rates.

Keywords: Care Bundle; instrumentation; operation in warm season; posterior cervical spine operation; surgical site infection.

背景： 提出了一项护理包以预防手术部位感染（SSI）。本研究调查了我院的SSI发生率和风险因素，开发了一个SSI预防护理包，并测试了其有效性。方法： 对2016年1月至2023年7月期间在全身麻醉下接受脊柱外科手术的1,117名患者进行了回顾性审查。共有764名患者（平均年龄69.7岁，58.0%为女性）被纳入研究。根据美国疾病控制和预防中心的指南诊断SSI。评估的风险因素包括患者因素、与手术相关因素、季节以及护理包实施情况（2019年4月引入）。护理包内容包括葡萄糖酸氯己定沐浴、皮肤消毒、高性能空气净化器、更换手套、含碘植入物覆盖布、预防性抗生素和术前海绵刷洗。结果： SSI发生率为2.6%（浅表感染0.7%，深层感染1.9%），在护理包实施前后分别从4.6%降至1.0%。风险因素包括吸烟（p = 0.003）、糖尿病（p = 0.025）、植入物使用（p = 0.039）、后颈椎手术（p = 0.049）和温暖季节（p = 0.024）。逻辑回归分析确定护理包实施（比值比[OR] 0.27，p = 0.013）、植入物使用（OR 3.59，p = 0.038）以及温暖季节（OR 3.63，p = 0.025）为独立因素。结论： 护理包有效地降低了SSI发生率。某些因素如植入物使用和在温暖季节进行手术与较高的SSI发生率相关。

关键词：护理包；植入物；温暖季节手术；后颈椎手术；手术部位感染。