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胃肠道手术后应用含庆大霉素的胶原植入物预防手术部位感染的局部应用。

Local application of gentamicin-containing collagen implant in the prophylaxis of surgical site infection following gastrointestinal surgery.

机构信息

Department of Colorectal Surgery, Maastad Hospital, Rotterdam, The Netherlands.

出版信息

Int J Surg. 2012;10 Suppl 1:S21-7. doi: 10.1016/j.ijsu.2012.05.014. Epub 2012 May 29.

Abstract

BACKGROUND

Gastrointestinal surgery is associated with one of the highest rates of SSI due to the nature of the surgery and to the added complication of operating on patients with significant co-morbidities. This high rate of SSI may negatively impact wound healing, patient recovery time, length of hospital stay and associated healthcare costs. This article provides an overview of the efficacy and safety of prophylactic application of resorbable gentamicin-containing collagen implants (GCCI) in the prevention of SSI following GI surgical procedures.

METHOD

Thirteen publications were identified using the PubMed online database and search terms 'gentamicin collagen implant' plus 'surgical site infection', 'wound infection' and 'gastrointestinal surgery'.

RESULTS

Eleven out of 13 studies have demonstrated that prophylactic use of GCCI can reduce the wound infection rate in high-risk GI surgical procedures (e.g. abdominoperineal resection [APR]) and improve wound healing after pilonidal sinus excision. GCCI may also have a role to play in preventing anastomotic leakage following mesorectal excision for rectal carcinoma. It is recommended that GCCI are used dry in line with the manufacturer's recommendations.

CONCLUSION

This review demonstrates that GCCI can significantly reduce surgical site infection following GI surgery including pilonidal sinus excision and high-risk procedures such as APR.

摘要

背景

由于手术的性质以及合并严重合并症患者手术的额外并发症,胃肠外科手术与最高的手术部位感染 (SSI) 发生率之一相关。这种高 SSI 发生率可能会对伤口愈合、患者恢复时间、住院时间和相关医疗保健成本产生负面影响。本文概述了在胃肠外科手术后预防 SSI 中预防性应用含庆大霉素可吸收胶原植入物 (GCCI) 的疗效和安全性。

方法

使用 PubMed 在线数据库和搜索词“庆大霉素胶原植入物”加“手术部位感染”、“伤口感染”和“胃肠外科”,确定了 13 篇出版物。

结果

13 项研究中有 11 项表明,预防性使用 GCCI 可以降低高风险胃肠外科手术(例如经腹会阴联合切除术 [APR])中的伤口感染率,并改善经皮窦道切除术(pilonidal sinus excision)后的伤口愈合。GCCI 在预防直肠系膜切除术后吻合口漏方面也可能发挥作用。建议按照制造商的建议干燥使用 GCCI。

结论

本综述表明,GCCI 可显著降低胃肠外科手术后的手术部位感染,包括经皮窦道切除术和 APR 等高危手术。

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