Division of Pediatric Surgery, Riley Hospital for Children, Indianapolis, IN 46202, USA.
J Pediatr Surg. 2010 Jul;45(7):1509-13. doi: 10.1016/j.jpedsurg.2009.10.054.
BACKGROUND/PURPOSE: There is little published data on the efficacy of surgical infection prophylaxis in children. The purpose of this study was to assess wound infection rate in children undergoing colostomy closure for imperforate anus and evaluate the impact of bowel preparation and antibiotics.
Children younger than 18 years with imperforate anus who had a colostomy closure between January 1996 and December 2007 were identified. Data collected included demographics, bowel preparation, antibiotics, operative details, and postoperative infections. Comparison of mechanical bowel preparation and intravenous antibiotics with and without oral antibiotics was compared using chi(2) tests. Significance was defined as P < .05.
A total of 118 patients were identified. Primary skin closure was done in 97%. Mechanical bowel preparation was used in 93%, intravenous antibiotics in 97%, and oral preoperative antibiotics in 52%. Wound infections occurred in 14% (n = 17). The addition of oral antibiotics to the standard regimen of mechanical bowel preparation with intravenous antibiotics did not alter infection rate (13% versus 17%, P = .64).
Wound infection in children undergoing elective colostomy closure for imperforate anus was 14%. Infection rate was not affected by use of oral antibiotics. Future studies may allow specific guideline development for infection prophylaxis in pediatric patients.
背景/目的：关于儿童手术感染预防的疗效，相关数据较少。本研究旨在评估行先天性肛门闭锁结肠造口关闭术患儿的伤口感染率，并评估肠道准备和抗生素的影响。
1996 年 1 月至 2007 年 12 月期间，我们对接受先天性肛门闭锁结肠造口关闭术的 18 岁以下儿童进行了研究。收集的数据包括人口统计学、肠道准备、抗生素、手术细节和术后感染情况。采用卡方检验比较机械性肠道准备和静脉用抗生素与有无口服抗生素的影响。P<0.05 为差异有统计学意义。
共纳入 118 例患儿。97%患儿行一期皮肤缝合。93%患儿接受机械性肠道准备，97%患儿接受静脉用抗生素，52%患儿接受术前口服抗生素。14%（17 例）患儿发生伤口感染。在标准的机械性肠道准备加静脉用抗生素方案中添加口服抗生素并未改变感染率（13%比 17%，P=0.64）。
择期行先天性肛门闭锁结肠造口关闭术的儿童中，伤口感染率为 14%。使用口服抗生素并未影响感染率。未来的研究可能为儿科患者的感染预防提供特定的指南制定依据。
