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头颈部重大肿瘤手术后伤口感染相关因素的初步报告——预防性抗生素的使用时长重要吗?

Preliminary report of associated factors in wound infection after major head and neck neoplasm operations--does the duration of prophylactic antibiotic matter?

作者信息

Liu S-A, Tung K-C, Shiao J-Y, Chiu Y-T

机构信息

Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan.

出版信息

J Laryngol Otol. 2008 Apr;122(4):403-8. doi: 10.1017/S0022215107007529. Epub 2007 Apr 20.

Abstract

The aim of this study was to investigate whether an extended course of prophylactic antibiotic could reduce the wound infection rate in a subtropical country. Fifty-three consecutive cases scheduled to receive major head and neck operations were randomised into one-day or three-day prophylactic antibiotic groups. Thirteen cases (24.5 per cent) developed wound infections after operations. The duration of prophylactic antibiotic was not related to the surgical wound infection. However, pre-operative haemoglobulin less than 10.5 g/dl (odds ratio: 7.24, 95 per cent confidence interval: 1.28-41.0) and reconstruction with a free flap or pectoris major myocutaneous flap during the operation (odds ratio: 11.04, 95 per cent confidence interval: 1.17-104.7) were associated factors significantly influencing post-operative wound infection. Therefore, one day of prophylactic antibiotic was effective in major head and neck procedures but should not be substituted for proper aseptic and meticulous surgical techniques.

摘要

本研究的目的是调查延长预防性抗生素疗程是否能降低一个亚热带国家的伤口感染率。五十三例计划接受重大头颈手术的连续病例被随机分为一日或三日预防性抗生素组。十三例(24.5%)术后发生伤口感染。预防性抗生素的使用时间与手术伤口感染无关。然而,术前血红蛋白低于10.5 g/dl(比值比:7.24,95%置信区间:1.28 - 41.0)以及手术期间使用游离皮瓣或胸大肌肌皮瓣进行重建(比值比:11.04,95%置信区间:1.17 - 104.7)是显著影响术后伤口感染的相关因素。因此,一日的预防性抗生素在重大头颈手术中是有效的,但不应替代适当的无菌和精细手术技术。

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