在阑尾炎手术中使用抗菌溶液冲洗以降低手术部位感染率。

Using antimicrobial solution for irrigation in appendicitis to lower surgical site infection rates.

机构信息

University of Texas Medical Branch, Galveston, TX, USA.

出版信息

Am J Surg. 2009 Dec;198(6):875-80. doi: 10.1016/j.amjsurg.2009.09.002.

DOI:10.1016/j.amjsurg.2009.09.002

PMID:19969145

Abstract

BACKGROUND

The use of antimicrobial solutions for irrigation in appendicitis is controversial. Numerous antiseptic and antibiotic solutions have been suggested for use as an intraoperative irrigant. We sought to determine whether there was a difference in postoperative surgical site infections (SSIs) comparing normal saline (.9%), antiseptic solution (Dakin's, .25%), and an antibiotic solution (imipenem 1 mg/mL).

METHODS

We performed a retrospective study of adult appendectomies from January 1997 through November 2007 at a single institution The data were evaluated by multivariate logistic regression analysis and chi-square test. The incidences of postoperative overall SSI, wound infection, and abdominal abscess were compared.

RESULTS

A total of 1,063 cases were identified. Saline (n = 661) had an SSI rate of 9.8% (65/661), a wound infection rate of 7.3% (48/661), and an abdominal abscess rate of 4.2% (28/661). Dakin's (n = 208) had an SSI rate of 20.7% (43/208), a wound infection rate of 15.9% (33/208), and an abdominal abscess rate of 9.1% (19/208). Imipenem (n = 194) irrigation had an SSI rate of .5% (1/194), a wound infection rate of .5% (1/194), and an abdominal abscess rate of .5% (1/194).

CONCLUSIONS

These results suggest that abdominal irrigation with an antibiotic solution (imipenem 1 mg/mL) is superior to both normal saline and Dakin's solution.

摘要

背景

在阑尾炎中使用抗菌溶液冲洗存在争议。已经提出了许多防腐剂和抗生素溶液作为术中冲洗液。我们试图确定与生理盐水（0.9%）、防腐剂溶液（Dakin's，0.25%）和抗生素溶液（亚胺培南 1mg/mL）相比，术后手术部位感染（SSI）是否存在差异。

方法

我们对 1997 年 1 月至 2007 年 11 月期间在一家机构进行的成人阑尾切除术进行了回顾性研究。数据通过多变量逻辑回归分析和卡方检验进行评估。比较了术后总体 SSI、伤口感染和腹部脓肿的发生率。

结果

共确定了 1063 例病例。生理盐水（n=661）的 SSI 发生率为 9.8%（65/661），伤口感染发生率为 7.3%（48/661），腹部脓肿发生率为 4.2%（28/661）。Dakin's（n=208）的 SSI 发生率为 20.7%（43/208），伤口感染发生率为 15.9%（33/208），腹部脓肿发生率为 9.1%（19/208）。亚胺培南（n=194）冲洗的 SSI 发生率为 0.5%（1/194），伤口感染发生率为 0.5%（1/194），腹部脓肿发生率为 0.5%（1/194）。