Fede A, Frascaroli D, Vento M G, Frezza D, Marchiori C
Clinica Otorinolaringoiatrica II, Università degli Studi di Padova-Treviso.
Ann Ital Chir. 1990 Mar-Apr;61(2):199-202.
Head and neck surgery presents a high operating risk of infectious complications. We agree upon the fact that 60% of the so-called infected operations would be complicated by secondary infections if they are not treated by antibiotic therapy. Such a premise justifies the more and more used application of a chemoprophylaxis in surgery, carried out preoperatively. The AA. report 81 cases of patients, from 15 o 70 years old (62 males, 19 females), subjected to head and neck surgery and subdivided into two groups according to the kind of the operation. I group: 40 patients subjected to operations of minor infectious risk, the whole number subjected only to the prophylactic pre-operational treatment with 1 gr. of Ceftriaxone by intravenous injection, 30-60 min. before the operation. II group: 41 patients subjected to infected operations: 21 patients treated with 1 gr. of Ceftriaxone by intravenous injection, 30-60 min. before the operation, and 20 patients treated with Cefazolin, 1 gr. per daily administration, carried out after the surgical operation. As dealing with infected operations of high risk infectious complications, the antibiotic treatment has been carried out for 7-8 days for all the patients. In operations with minor infectious risk (group I) we have had a good post-operational course, without any infectious complication; the use of Ceftriaxone, with only one preoperational dose, is extremely useful for this group of patients. In infected operations of head and neck oncological surgery (group II) the cases of infectious complications have been 2 in the subgroup treated with Ceftriaxone, and 4 in the subgroup treated with Cefazolin.(ABSTRACT TRUNCATED AT 250 WORDS)
头颈外科手术存在较高的感染并发症手术风险。我们认同这样一个事实:如果不采用抗生素治疗,那么60%的所谓感染性手术会因继发感染而出现并发症。这一前提证明了术前越来越多地应用化学预防措施在外科手术中的合理性。作者报告了81例患者,年龄在15至70岁之间(男性62例,女性19例),接受了头颈外科手术,并根据手术类型分为两组。第一组:40例患者接受感染风险较小的手术,全体仅在术前30 - 60分钟通过静脉注射1克头孢曲松进行预防性术前治疗。第二组:41例患者接受感染性手术:21例患者在术前30 - 60分钟通过静脉注射1克头孢曲松进行治疗,20例患者在手术后每天给予1克头孢唑林进行治疗。由于涉及高感染并发症风险的感染性手术,所有患者的抗生素治疗均持续7 - 8天。在感染风险较小的手术(第一组)中,术后过程良好,未出现任何感染并发症;对于这组患者,仅使用一剂术前头孢曲松非常有用。在头颈肿瘤外科的感染性手术(第二组)中,接受头孢曲松治疗的亚组中有2例出现感染并发症,接受头孢唑林治疗的亚组中有4例出现感染并发症。(摘要截选至250字)