N.N. Priorov Journal of Traumatology and OrthopedicsN.N. Priorov Journal of Traumatology and OrthopedicsВестник травматологии и ортопедии им. Н.Н. Приорова0869-86782658-6738Eco-Vector63644610.17816/vto636446Original study articlesОригинальные исследованияResearch ArticleInformation technologies for supporting prevention, diagnosis and management of surgical site infections in trauma and orthopedic patientsИспользование информационных технологий для поддержки процессов профилактики, диагностики и лечения инфекций области хирургического вмешательства у пациентов травматолого-ортопедического профиляhttps://orcid.org/0000-0003-1314-28871402-5186NazarenkoAnton G.НазаренкоАнтон Герасимович
Russian Federation

MD, Dr. Sci. (Medicine), рrofessor

д-р мед. наук, профессор

NazarenkoAG@cito.priorov.ruhttps://orcid.org/0000-0002-8745-61952037-7164KleimenovaElena B.КлеймёноваЕлена Борисовна
Russian Federation

MD, Dr. Sci. (Medicine), рrofessor

д-р мед. наук, профессор

KleymenovaEB@cito-priorov.ruhttps://orcid.org/0000-0002-4090-29288710-6504DronovMikhail A.ДроновМихаил Александрович
Russian Federation
mikhail.dronov@gmail.comhttps://orcid.org/0000-0001-8938-23217686-2123GorbatyukDmitry S.ГорбатюкДмитрий Сергеевич
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

GorbatyukDS@cito-priorov.ruhttps://orcid.org/0000-0002-2380-23946321-6733KakabadzeNodari M.КакабадзеНодари Малхазович
Russian Federation

MD

KakabadzeNM@cito-priorov.ruhttps://orcid.org/0000-0003-1721-282X2312-1002TsiskarashviliArchil V.ЦискарашвилиАрчил Важаевич
Russian Federation

MD, MD, Cand. Sci. (Medicine)

канд. мед. наук

TsiskarashviliAV@cito-priorov.ruhttps://orcid.org/0000-0002-3330-3193GerasimovaNatalia P.ГерасимоваНаталия Павловна
Russian Federation
GerasimovaNP@cito-priorov.ruhttps://orcid.org/0009-0006-2350-7201YurchenkovaEkaterina S.ЮрченковаЕкатерина Сергеевна
Russian Federation
YurchenkovaES@cito-priorov.ruhttps://orcid.org/0000-0003-1357-00561910-0484YashinaLiubov P.ЯшинаЛюбовь Петровна
Russian Federation

Cand. Sci. (Biol.)

канд. биол. наук

YashinaLP@cito-priorov.ruPriorov National Medical Research Center for Traumatology and OrthopedicsНациональный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. ПриороваLomonosov Moscow State UniversityМосковский государственный университет им. М.В. Ломоносова28102024251220243144674792409202407102024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://journals.eco-vector.com/0869-8678/article/view/636446

BACKGROUND: Surgical site infections (SSIs) are one of the most common preventable healthcare-associated infections, with a significant socioeconomic burden. Information technology, particularly clinical decision support systems, has been shown to improve patient safety. However, there have been few publications on the use of these systems for the prevention and treatment of SSIs.

AIM: To develop a multifunctional patient safety information system (PSIS) for the prevention, diagnosis, and treatment of SSIs in traumatic and orthopedic surgery.

MATERIALS AND METHODS: A PSIS for traumatic and orthopedic surgeons was developed and implemented in the N.N. Priorov National Medical Research Center of Traumatology and Orthopedics in late 2023 to early 2024. The PSIS includes two user systems: 1) an analytical and authoring system (PSIS-Manager) for subject matter experts who develop scenarios; 2) a medical system for patient data entry and access to guidelines.

RESULTS: A PSIS prevention scenario was developed based on the guidelines of the National Association of Infectious and Non-Infectious Disease Control Professionals. It includes 11 recommendations for the preoperative stage, 30 for the perioperative and intraoperative stages, 33 for SSI prevention during surgery, and 7 for the postoperative stage. A surgical antibiotic prophylaxis scenario includes 24 recommendations. Decision-making algorithms for the treatment of SSIs are based on the guidelines of the American Academy of Orthopaedic Surgeons (AAOS). Decision-making involves 6 factors providing 264 various clinical scenarios, with 9 decision options.

CONCLUSION: Scenario-based protocols can be used to support decision-making on patient management strategy, as well to control compliance with SSI prevention and treatment guidelines. Further perspectives on PSIS development in terms of SSI diagnosis and treatment include the use of artificial intelligence technologies to aid in the diagnosis of wound infections and the selection of treatment options.

Обоснование. Инфекции области хирургического вмешательства (ИОХВ) являются одними из самых распространённых предотвратимых инфекций, связанных с оказанием медицинской помощи, и представляют собой значительное социально-экономическое бремя. Доказана эффективность цифровых технологий, в частности систем поддержки принятия врачебных решений, в повышении безопасности пациентов, однако публикаций о внедрении этих систем для профилактики и лечения ИОХВ немного.

Цель. Разработка многофункциональной информационной системы по безопасности пациентов (ИСБП) травматолого-ортопедического профиля в части профилактики, диагностики и лечения ИОХВ.

Материалы и методы. ИСБП для травматологов и ортопедов была разработана и внедрена в ФГБУ НМИЦ травматологии и ортопедии им. Н.Н. Приорова в конце 2023 — начале 2024 г. ИСБП включает две пользовательские системы: 1) аналитико-авторскую (ИСБП-Менеджер), предназначенную для экспертов предметной области, формирующих сценарии; 2) врачебную, предназначенную для ввода данных о пациентах и просмотра рекомендаций.

Результаты. Сценарий профилактики ИСБП разработан на основании методических рекомендаций НАСКИ, в нём предусмотрено 11 рекомендаций для предоперационного этапа, 30 — для пери- и интраоперационного этапа, 33 рекомендации по профилактике ИОХВ в операционной и 7 — для послеоперационного периода. Сценарий хирургической антибиотикопрофилактики содержит 24 рекомендации. В основе алгоритмов принятия решений о лечении ИОХВ лежат рекомендации Американской ассоциации ортопедических хирургов AAOS. В принятии решения участвуют 6 факторов, дающих 264 различные клинические ситуации, для которых предусмотрено 9 вариантов решений.

Заключение. Формируемые в результате заполнения сценариев протоколы могут не только служить для поддержки принятия решения о тактике ведения пациента, но и выступать в качестве инструмента для контроля соблюдения рекомендаций по профилактике и лечению ИОХВ. Дальнейшие перспективы развития ИСБП в части диагностики и лечения ИОХВ связаны с использованием технологий искусственного интеллекта для поддержки процессов диагностики раневой инфекции и выработки тактики её лечения.

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