清洁的普通外科手术病例无需预防性使用抗生素。
Prophylactic antibiotics are not indicated in clean general surgery cases.
作者信息
Knight R, Charbonneau P, Ratzer E, Zeren F, Haun W, Clark J
机构信息
Department of Surgery Education, Exempla Saint Joseph Hospital, 1835 Franklin St., Denver, CO 80218-1191, USA.
出版信息
Am J Surg. 2001 Dec;182(6):682-6. doi: 10.1016/s0002-9610(01)00823-6.
BACKGROUND
In assigning risk of infection, the traditional wound classification system has been replaced by the National Nosocomial Infection Surveillance (NNIS) system. NNIS classification is determined by procedure length, wound cleanliness, and ASA status. To date, no prophylactic antibiotic guidelines have been proposed for the NNIS system.
METHODS
Clean general surgery cases were retrospectively reviewed in our hospital for infection and prophylactic antibiotic use. These cases were then stratified per the NNIS system.
RESULTS
One thousand twenty-three clean general surgery cases had 16 (1%) surgical site infections. The infection rate in NNIS class 0, 1, and 2 cases not given prophylactic antibiotics was 1.21%, 3.03%, and 0%, respectively. The infection rate in NNIS class 0, 1, and 2 cases given prophylactic antibiotics was 0.94%, 2.44%, and 6.67%, respectively.
CONCLUSIONS
No statistically significant decrease in infection rate was demonstrated by us using prophylactic antibiotics, regardless of the NNIS classification in clean general surgery cases.
背景
在确定感染风险时，传统的伤口分类系统已被国家医院感染监测（NNIS）系统所取代。NNIS分类由手术时长、伤口清洁度和美国麻醉医师协会（ASA）分级决定。迄今为止，尚未针对NNIS系统提出预防性抗生素使用指南。
方法
我们对本院清洁普通外科手术病例的感染情况和预防性抗生素使用情况进行了回顾性研究。然后根据NNIS系统对这些病例进行分层。
结果
1023例清洁普通外科手术病例中有16例（1%）发生手术部位感染。未使用预防性抗生素的NNIS 0级、1级和2级病例的感染率分别为1.21%、3.03%和0%。使用预防性抗生素的NNIS 0级、1级和2级病例的感染率分别为0.94%、2.44%和6.67%。
结论
在清洁普通外科手术病例中，无论NNIS分类如何，我们使用预防性抗生素均未显示出感染率有统计学意义的下降。
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