Dunn John C, Fares Austin B, Kusnezov Nicholas, Pirela-Cruz Miguel, Gonzalez Gilberto, Orr Justin D, Pallis Mark
William Beaumont Army Medical Center, Fort Bliss, TX, USA.
Creighton University School of Medicine, Omaha, NE, USA.
Hand (N Y). 2018 May;13(3):259-263. doi: 10.1177/1558944717701241. Epub 2017 Mar 27.
Although routine antibiotic prophylaxis immediately preceding an orthopedic surgery has become the standard of care in most cases, this practice is poorly defined in hand surgery. The purpose of this analysis is to review the most current literature of antibiotic use in hand surgery. A careful review of the literature regarding routine antibiotic prophylaxis in hand surgery was made. Current relevant resources were used in the construction of this review. There is a mixed consensus on the role for prophylactic antibiotics in hand surgery with some resources and data showing support and others opposed. Based on the current literature, the authors recommend the following patient characteristics not receive antibiotics: clean hygienic patients, without autoimmune disease, and those not taking steroid medication. Surgical characteristics that would render prophylaxis unnecessary include those without hardware, those without reasonable risk of hematoma formation, or those performed at an ambulatory surgery center as opposed to a large hospital. However, the decision should be made on a case-by-case basis weighing the evidence presented.
尽管在大多数情况下，骨科手术前立即进行常规抗生素预防已成为护理标准，但这种做法在手外科中定义并不明确。本分析的目的是回顾手外科中抗生素使用的最新文献。对手外科常规抗生素预防的文献进行了仔细回顾。在本综述的构建过程中使用了当前的相关资源。关于预防性抗生素在手外科中的作用存在不同的共识，一些资源和数据表示支持，而另一些则持反对意见。基于当前文献，作者建议以下患者特征不使用抗生素：清洁卫生的患者、无自身免疫性疾病的患者以及未服用类固醇药物的患者。无需进行预防的手术特征包括无植入物的手术、无形成血肿合理风险的手术，或在门诊手术中心而非大型医院进行的手术。然而，应根据具体情况权衡所提供的证据后做出决定。
