Gil Ziv, Patel Snehal G, Bilsky Mark, Shah Jatin P, Kraus Dennis H
Department of Otolaryngology, Head and Neck Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
Otolaryngol Head Neck Surg. 2009 Feb;140(2):218-23. doi: 10.1016/j.otohns.2008.10.042.
To determine the rate and type of complications after craniofacial resection (CFR) during the most recent 10-year period in comparison to a historic control.
Patients underwent CFR in 1973-1995 ("earlier" period; n = 114) and in 1996-2005 ("later" period; n = 120) before and after a broad-spectrum antibiotic regime was used.
In the later period patients had higher rates of comorbidity, dural invasion, high-grade malignancy, and wide resections (P < 0.02). Complications were identified in 52 percent of the early and 33 percent of the later groups (P = 0.002). There was 20 percent decrease in wound complications in the later period (P < 0.0001), but not in other complications. In the earlier period, complications were evenly distributed between patients younger and older than 50 years. However, in the later period, most complications occurred among elderly patients. Multivariate analysis revealed that a broad-spectrum antibiotic regime was associated with a lower complication rate (P = 0.02).
Complication rates decreased during the last 10 years due to a decline in wound infections. Broad-spectrum antibiotic coverage probably contributed to this change.
与历史对照组相比，确定最近10年颅面切除术（CFR）后并发症的发生率和类型。
1973 - 1995年（“早期”；n = 114）和1996 - 2005年（“后期”；n = 120）期间接受CFR的患者，分别在使用广谱抗生素方案之前和之后。
后期患者的合并症、硬脑膜侵犯、高级别恶性肿瘤和广泛切除率更高（P < 0.02）。早期组并发症发生率为52%，后期组为33%（P = 0.002）。后期伤口并发症减少了20%（P < 0.0001），但其他并发症无此变化。在早期，并发症在50岁及以上和50岁以下患者中分布均匀。然而，在后期，大多数并发症发生在老年患者中。多变量分析显示，广谱抗生素方案与较低的并发症发生率相关（P = 0.02）。
由于伤口感染减少，过去10年并发症发生率降低。广谱抗生素覆盖可能促成了这一变化。
