Carroll William R, Rosenstiel David, Fix Jobe R, de la Torre Jorge, Solomon Joel S, Brodish Brian, Rosenthal Eben L, Heinz Tad, Niwas Santosh, Peters Glenn E
Division of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, 35233, USA.
Arch Otolaryngol Head Neck Surg. 2003 Jul;129(7):771-4. doi: 10.1001/archotol.129.7.771.
Twenty-four hours of perioperative antibiotics provides effective prophylaxis for most head and neck cancer resections. Many reconstructive surgeons have been hesitant to apply this standard to free-flap reconstruction of the head and neck. This prospective clinical trial compared short-course and long-course clindamycin prophylaxis for wound infection in patients with head and neck cancer undergoing free-flap reconstruction.
Seventy-four patients were randomized to receive short-course (3 doses) or long-course (15 doses) clindamycin perioperatively. Wound infections, fistulas, and other postoperative complications were documented by faculty surgeons who were blinded as to treatment group.
The differences in wound infections and other complications were statistically insignificant. No other independent predictors of wound complications emerged in this series of patients.
Short-course clindamycin is as effective as long-course clindamycin in preventing wound infections after free-flap surgery for head and neck ablative defects.
围手术期24小时使用抗生素可为大多数头颈癌切除术提供有效的预防措施。许多重建外科医生一直不愿将这一标准应用于头颈游离皮瓣重建手术。这项前瞻性临床试验比较了短期和长期使用克林霉素预防头颈癌游离皮瓣重建患者伤口感染的效果。
74例患者被随机分为围手术期接受短期（3剂）或长期（15剂）克林霉素治疗组。伤口感染、瘘管及其他术后并发症由对治疗组不知情的外科医生记录。
伤口感染及其他并发症的差异无统计学意义。在这组患者中未发现其他伤口并发症的独立预测因素。
在预防头颈切除术后游离皮瓣手术伤口感染方面，短期使用克林霉素与长期使用克林霉素效果相同。
