Anlicoara Rafael, Ferraz Álvaro A B, da P Coelho Kilma, de Lima Filho José L, Siqueira Luciana T, de Araújo José G C, Campos Josemberg M, Ferraz Edmundo M
Department of Plastic Surgery, UFPE, Recife, Pernambuco, Brazil,
Obes Surg. 2014 Sep;24(9):1487-91. doi: 10.1007/s11695-014-1231-0.
The aim of this study was to evaluate the concentration of cefazolin in adipose tissue of patients undergoing bariatric surgery.
Eighteen patients undergoing bariatric surgery were evaluated during the period from October 2011 to May 2012. All patients had a dosage schedule of antibiotic prophylaxis with cefazolin administered as follows: first, 2 g in anesthetic induction, followed by continuous infusion of 1 g diluted in 250 ml of saline solution. Adipose samples, collected soon after the incision (initial) and before the skin synthesis (final), were analyzed using reverse phase high-pressure liquid chromatography. The level of significance adopted was 5 %.
The cefazolin concentration in the adipose tissue samples at the beginning of surgery was an average of 6.66 ± 2.56 ug/ml. The mean concentration before the skin synthesis was 7.93 ± 2.54 ug/ml. Patients with BMI < 40 kg/m(2) had higher initial and final sample concentrations of cefazolin than patients with BMI ≥ 40 kg/m(2). There was no surgical site infection (SSI) in any of the patients.
In bariatric surgeries, addition of a 1 g increase of cefazolin, administered through continuous intravenous infusion, to the currently recommended dose of 2 g administered in anesthetic induction provided a concentration in the adipose tissue above the minimum inhibitory concentration (MIC) of the main causal agents of SSI. An inverse correlation between BMI and concentration of cefazolin in adipose tissue was observed.
本研究旨在评估接受减肥手术患者脂肪组织中头孢唑林的浓度。
对2011年10月至2012年5月期间接受减肥手术的18例患者进行评估。所有患者的抗生素预防用药方案为头孢唑林，给药方式如下：首先，麻醉诱导时给予2g，随后以1g稀释于250ml盐溶液中持续输注。在切口后不久（初始）和皮肤缝合前（最终）采集脂肪样本，采用反相高效液相色谱法进行分析。采用的显著性水平为5%。
手术开始时脂肪组织样本中头孢唑林的平均浓度为6.66±2.56μg/ml。皮肤缝合前的平均浓度为7.93±2.54μg/ml。体重指数（BMI）<40kg/m²的患者头孢唑林初始和最终样本浓度高于BMI≥40kg/m²的患者。所有患者均未发生手术部位感染（SSI）。
在减肥手术中，在麻醉诱导时给予目前推荐剂量2g的基础上，通过持续静脉输注额外增加1g头孢唑林，可使脂肪组织中的浓度高于SSI主要致病菌的最低抑菌浓度（MIC）。观察到BMI与脂肪组织中头孢唑林浓度呈负相关。
