From the Department of Cranio-Maxillofacial Surgery (M.M., R.W., P.L.S., O.L., K.N., B.S.), Inselspital University Hospital Bern, Switzerland; and Department of Oral and Maxillofacial Surgery (P.L.S.), National Dental Centre, Singapore.
J Trauma Acute Care Surg. 2014 Mar;76(3):720-4. doi: 10.1097/TA.0000000000000123.
The goal of this study was to evaluate the influence of the duration of postoperative antibiotics (1 day vs. ≥ 5 days) on wound infections following surgical treatment of facial fractures.
Three hundred thirty-nine patient case histories with a total of 498 fractures were reviewed retrospectively with regard to infections occurring within a 6-month period following surgical management. Patients were divided into two groups based on the duration of postoperative antibiotics administered. Group A consisted of 125 patients who had 1 day of postoperative antibiotics, whereas Group B consisted of 214 patients who had five or more days of postoperative antibiotics. Statistical analysis was conducted to assess for possible differences in the rate of postoperative infections.
Five patients in Group A (4%) and seven patients in Group B (3.27%) developed infections within the follow-up period. Of these 12 patients, seven had sustained multiple facial bone fractures. Eleven infections occurred in patients with mandibular fractures and one in a midfacial fracture. Statistical analysis using Fisher's exact test showed no significant difference (p = 0.77) in the incidence of infection between Groups A and B.
In this retrospective study, the use of prolonged postoperative antibiotics in uncomplicated mandibular and midfacial fractures had no significant benefit in reducing the incidence of infections.
Therapeutic study, level IV.
本研究旨在评估术后抗生素使用时间(1 天与≥5 天)对面部骨折手术后伤口感染的影响。
回顾性分析了 339 例患者的病历,共涉及 498 处骨折,随访时间为术后 6 个月内发生的感染。根据术后抗生素使用时间将患者分为两组。A 组 125 例患者术后使用 1 天抗生素,B 组 214 例患者术后使用 5 天或以上抗生素。采用统计学方法分析术后感染率的差异。
A 组 5 例(4%)和 B 组 7 例(3.27%)患者在随访期间发生感染。这 12 例患者中,7 例存在多处面部骨折。11 例感染发生在下颌骨骨折患者中,1 例发生在面中部骨折患者中。Fisher 确切概率法统计分析显示,A 组和 B 组感染发生率无显著差异(p=0.77)。
在本回顾性研究中,对于无并发症的下颌骨和面中部骨折,延长术后抗生素使用时间并不能显著降低感染发生率。
治疗性研究,IV 级。