Vennits B P, Bauer T, Hahn-Pedersen J, Galatius H, Lysen D, Holm B, Kristensen E S, Graversen P H, Wilhelmsen F S, Skjoldborg H
Naestved Centralsygehus, parenkymkirurgisk afdeling.
Ugeskr Laeger. 1990 Jan 15;152(3):157-60.
In order to illustrate which factors are of significance for the development of wound infection after appendectomy, an extensive prospective material of 2,097 patients submitted to appendectomy was analysed. Regression analyses demonstrated that age alone, employment of preoperative antibiotics (cefoxitin) and patient delay (time from onset of symptoms till admission) were of significance. The present authors conclude, on the basis of this material, that all patients over 25 years of age should be given preoperative antibiotic prophylaxis which covers aerobic and also anaerobic microorganisms. If a gangrenous or perforated appendix is found, antibiotics should be administered intraoperatively if prophylactic treatment has not been administered. In cases of perforation, antibiotics should be administered postoperatively for 72 hours.
为了阐明哪些因素对阑尾切除术后伤口感染的发生具有重要意义,对2097例行阑尾切除术患者的大量前瞻性资料进行了分析。回归分析表明,仅年龄、术前使用抗生素(头孢西丁)以及患者延迟(从症状出现到入院的时间)具有重要意义。基于这些资料,作者得出结论,所有25岁以上的患者都应给予覆盖需氧菌和厌氧菌的术前抗生素预防。如果发现坏疽性或穿孔性阑尾,若未进行预防性治疗,则应在术中使用抗生素。对于穿孔病例,术后应使用抗生素72小时。