Georgiou Ioannis, Farber Nimrod, Mendes David, Winkler Eyal
Department of Plastic & Reconstructive Surgery, The Chaim Sheba Medical Center, Affiliated to the Tel-Aviv University, Sackler School of Medicine, Tel-Hashomer, Israel.
Rhinology. 2008 Dec;46(4):267-70.
Prophylactic antimicrobial therapy during nasal surgery is common among surgeons worldwide, although the effectiveness of this practice is controversial. The authors reviewed the literature to evaluate the value of antibiotic prophylaxis.
A MEDLINE search was preformed using the key terms septoplasty, rhinoplasty, infections and antibiotics. The authors identified eleven studies written in English or German that addressed the effectiveness of prophylactic antibiotics, infection rate and bacteremia during nasal surgery. Due to the small number of studies statistical re-analysis was discarded.
The articles demonstrated an overall very low incidence of bacteremia or infection. The studies failed to demonstrate a difference between patients who received antibiotic prophylaxis during nasal surgery and patients who did not; with the only exception being cases of complicated revision rhinoplasties.
Our review suggests that the infection rate after elective nasal surgery is very low, making routine antibiotic prophylaxis redundant. Preventive systemic antibiotics are indicated in complicated revision rhinoplasties, prolonged placement of nasal packs and for patients who are susceptible to infections.
尽管鼻腔手术期间预防性使用抗菌药物的有效性存在争议，但全球范围内的外科医生普遍采用这种做法。作者回顾了相关文献以评估抗生素预防的价值。
使用鼻中隔成形术、鼻整形术、感染和抗生素等关键词在医学文献数据库（MEDLINE）中进行检索。作者确定了11篇用英语或德语撰写的研究，这些研究探讨了鼻腔手术期间预防性使用抗生素的有效性、感染率和菌血症情况。由于研究数量较少，未进行统计重新分析。
文章显示菌血症或感染的总体发生率非常低。研究未能证明在鼻腔手术期间接受抗生素预防的患者与未接受预防的患者之间存在差异；唯一的例外是复杂的鼻整形修复病例。
我们的综述表明，择期鼻腔手术后的感染率非常低，常规抗生素预防是多余的。预防性全身使用抗生素适用于复杂的鼻整形修复手术、鼻腔填塞时间延长的情况以及易感染的患者。
