Danda Anil Kumar, Ravi Poornima
Department of Oral and Maxillofacial Surgery, Saveetha Dental College, Saveetha University, Chennai, India.
J Oral Maxillofac Surg. 2011 Oct;69(10):2650-6. doi: 10.1016/j.joms.2011.02.060. Epub 2011 May 6.
To conduct a systematic review of published clinical trials on the effectiveness of extended postoperative antibiotics in orthognathic surgery.
Electronic databases were searched for randomized clinical trials. Data from relevant articles were extracted and assessed. The primary outcome variable was surgical site infection. Extracted data were analyzed using a meta-analytical program with a random effects model.
In total 532 patients were assessed in 8 clinical trials. Wound infection occurred in 30 of 268 patients in the short-term prophylaxis group (frequency, 11.2%) and in 10 of 264 patients in the extended-term group (frequency, 3.8%). Extended antibiotic therapy was more effective in decreasing the risk of postoperative wound infection (odds ratio, 3.2; number needed to treat, 13.5).
Extended postoperative antibiotic treatment does have a place in decreasing the risk of postoperative wound infection in orthognathic surgery. More trials are needed to standardize a proper regimen.
对已发表的关于正颌外科术后延长使用抗生素有效性的临床试验进行系统评价。
检索电子数据库以查找随机临床试验。提取并评估相关文章的数据。主要结局变量为手术部位感染。使用随机效应模型的荟萃分析程序对提取的数据进行分析。
8项临床试验共评估了532例患者。短期预防组268例患者中有30例发生伤口感染（发生率，11.2%），延长治疗组264例患者中有10例发生伤口感染（发生率，3.8%）。延长抗生素治疗在降低术后伤口感染风险方面更有效（优势比，3.2；需治疗人数，13.5）。
术后延长抗生素治疗在降低正颌外科术后伤口感染风险方面确实有一定作用。需要更多试验来规范合适的治疗方案。
