Mangwani J, Gulati A, Benson R, Cichero M, Williamson D M
Consultant in Trauma and Orthopaedics, University Hospitals of Leicester, NHS Trust, UK.
Specialist Registrar in Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, UK.
Foot Ankle Surg. 2017 Mar;23(1):50-52. doi: 10.1016/j.fas.2016.02.004. Epub 2016 Feb 17.
This prospective randomised controlled trial was performed to determine whether the incidence of local infection is reduced in patients who are administered prophylactic antibiotics for lesser toe fusion surgery.
100 adult patients undergoing toe fusion surgery that required K-wires to be left in situ for 4-6 weeks were randomly allocated into those who received prophylactic antibiotics (Group 1, n=48) and those who did not (Group 2, n=52). Patients were followed up regularly and during each visit K-wire insertion sites were assessed for signs of pin tract infection.
The mean age of Group 1 was 58.0 (SD 17.5) and Group 2 was 62.7 years (SD 14.7). The overall infection rate was 4%. Three patients (6.2%) in Group 1 and one patient (1.9%) in Group 2 developed signs of infection, which required treatment by oral antibiotics. All infections were low grade. There were no features suggestive of osteomyelitis in any of the patients.
The overall infection rate in lesser toe fusion surgery is low and that using prophylactic antibiotics does not reduce the incidence. Inappropriate use of antibiotics, however, may contribute to the development of antibiotic resistance and adds to healthcare costs.
开展这项前瞻性随机对照试验，以确定在小趾融合手术中接受预防性抗生素治疗的患者局部感染发生率是否降低。
100例接受趾融合手术且需将克氏针原位留置4 - 6周的成年患者被随机分为接受预防性抗生素治疗的患者（第1组，n = 48）和未接受预防性抗生素治疗的患者（第2组，n = 52）。对患者进行定期随访，每次随访时评估克氏针插入部位有无针道感染迹象。
第1组的平均年龄为58.0岁（标准差17.5），第2组为62.7岁（标准差14.7）。总体感染率为4%。第1组有3例患者（6.2%）出现感染迹象，需口服抗生素治疗，第2组有1例患者（1.9%）出现感染迹象。所有感染均为轻度。所有患者均无提示骨髓炎的特征。
小趾融合手术的总体感染率较低，使用预防性抗生素并不能降低感染发生率。然而，不恰当使用抗生素可能导致抗生素耐药性的产生，并增加医疗成本。
