MacLean L D
Can J Surg. 1975 May;18(3):243-7.
Prophylactic (preventive) antibiotic therapy initiated preoperatively, with antibiotics administered in moderately high dosage for short periods, is recommended on the basis of experimental and prospective, randomized clinical trials for patients who require surgery that is likely to expose tissue planes to contamination. The value of prophylactic antibiotics in clean operations is not presently supported but must be considered in patients with decreased resistance and in those in whom infection of a prosthesis would have catastrophic results. In these patients topical antibiotics might prove useful and less dangerous. It is clear that surgical technique remains an important but as yet unmeasured factor in wound infection.
根据实验以及前瞻性随机临床试验结果，对于需要进行可能使组织层面暴露于污染风险手术的患者，建议在术前开始预防性抗生素治疗，短期内给予中等高剂量的抗生素。目前，预防性抗生素在清洁手术中的价值尚无定论，但对于抵抗力下降的患者以及假体感染会导致灾难性后果的患者，必须考虑使用。对于这些患者，局部使用抗生素可能被证明是有用且危险性较小的。很明显，手术技术仍然是伤口感染中一个重要但尚未量化的因素。
