Schulze T, Napp M, Maier S
Klinik und Poliklinik für Allgemeine Chirurgie, Visceral-, Thorax- und Gefäßchirurgie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland,
Hautarzt. 2014 Jan;65(1):32-8. doi: 10.1007/s00105-013-2637-7.
In Germany, over half a million operations are done in dermatologic surgery in a hospital setting every year, as well as a less well quantified number of procedures in private offices. In spite of this large number, specific guidelines concerning the use of perioperative antibiotics in dermatologic surgery are sparse. In contrast to procedures in general, visceral or gynecological surgery, general guidelines on perioperative antibiotics issued by the Paul-Ehrlich Institutes and the AWMF do not specifically consider dermatologic operations. Several surveys indicate that familiarity with current recommendations on perioperative antibiotics is suboptimal and resulted in a considerable overuse of perioperative antibiotics in dermatologic surgery. Given the increasing antimicrobial resistance among important pathogens and the inherent risks of antibiotic administration, the decision for the use of prophylactic antibiotics should be based on the individual risk profile of the patient and of the surgical procedure. In the following, we will critically discuss the evidence for perioperative antibiotics in dermatologic surgery.
在德国，每年有超过50万例皮肤科手术在医院环境中进行，此外，私人诊所进行的手术数量虽难以精确量化，但也不少。尽管手术数量众多，但关于皮肤科手术围手术期抗生素使用的具体指南却很稀少。与普通外科、内脏外科或妇科手术不同，保罗·埃利希研究所和德国医学科学院（AWMF）发布的围手术期抗生素通用指南并未特别考虑皮肤科手术。多项调查表明，对围手术期抗生素当前建议的熟悉程度并不理想，导致皮肤科手术中围手术期抗生素的使用存在相当程度的过度现象。鉴于重要病原体的抗菌耐药性不断增加以及抗生素给药的固有风险，预防性抗生素的使用决策应基于患者和手术程序的个体风险状况。以下，我们将批判性地讨论皮肤科手术中围手术期使用抗生素的证据。
