肥胖女性行子宫切除术联合医学指征行腹直肌前鞘成形术时，延长抗生素预防用药时间以预防手术部位感染：一项队列研究。

Extended antibiotic prophylaxis for prevention of surgical-site infections in morbidly obese women who undergo combined hysterectomy and medically indicated panniculectomy: a cohort study.

机构信息

Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

Am J Obstet Gynecol. 2010 Mar;202(3):306.e1-9. doi: 10.1016/j.ajog.2010.01.053.

DOI:10.1016/j.ajog.2010.01.053

PMID:20207249

Abstract

OBJECTIVE

The purpose of this study was to compare surgical-site infection rates in obese women who had extended prophylactic antibiotic (EPA) vs standard prophylactic antibiotic.

STUDY DESIGN

An electronic records-linkage system identified 145 obese women (body mass index, >30 kg/m(2)) who underwent combined hysterectomy and panniculectomy from January 1, 2005, through December 31, 2008. The EPA cohort received standard antibiotics (cefazolin, 2 g) and continued oral antibiotic (ciprofloxacin) until removal of drains. Regression models were used to adjust for known confounders.

RESULTS

The mean age was 56.0 + or - 12.1 years, and mean body mass index was 42.6 + or - 8.4 kg/m(2) (range, 30-86.4 kg/m(2)). The EPA cohort experienced fewer surgical-site infections (6 [5.9%] vs 12 [27.9%]; P < .001; adjusted odds ratio, 0.16; 95% confidence interval, 0.04-0.51; P < .001), had lower probability of incision and drainage (3 [2.9%] vs 5 [11.6%]; P = .05), and required fewer infection-related admissions (5 [4.9%] vs 6 [13.9%]; P = .08).

CONCLUSION

Extended antibiotic prophylaxis can reduce surgical-site infections in obese women after combined hysterectomy and panniculectomy.

摘要

目的

本研究旨在比较接受延长预防性抗生素（EPA）与标准预防性抗生素的肥胖女性的手术部位感染率。

研究设计

电子病历链接系统确定了 145 名肥胖女性（体重指数 >30 kg/m(2)），这些女性于 2005 年 1 月 1 日至 2008 年 12 月 31 日期间接受了联合子宫切除术和腹带切除术。EPA 队列接受标准抗生素（头孢唑啉，2 g）和持续口服抗生素（环丙沙星），直至引流管移除。回归模型用于调整已知的混杂因素。

结果

平均年龄为 56.0±12.1 岁，平均体重指数为 42.6±8.4 kg/m(2)（范围 30-86.4 kg/m(2)）。EPA 队列的手术部位感染率较低（6 [5.9%] 例比 12 [27.9%] 例；P <.001；调整后的优势比，0.16；95%置信区间，0.04-0.51；P <.001），切口和引流的可能性较低（3 [2.9%] 例比 5 [11.6%] 例；P =.05），与感染相关的住院治疗次数较少（5 [4.9%] 例比 6 [13.9%] 例；P =.08）。