Smith Jacob, Patel Ashay, Zamilpa Ismael, Bai Shasha, Alliston Jeffrey, Canon Stephen
Pediatric Urology Division, Arkansas Children's Hospital, Little Rock, Arkansas, USA.
Can J Urol. 2017 Apr;24(2):8765-8769.
Surgical site infection [SSI] is a risk for any surgical procedure, including hypospadias repair. Prophylactic antibiotic therapy for patients having surgery is often effective in preventing SSIs, but with increasing rates of antibiotic resistance, this practice has been questioned. The objectives of this study are 1) to assess the incidence of SSIs in patients following stented, distal hypospadias repair and 2) to observe for any potential difference in the incidence of SSIs for patients with and without preoperative antibiotic utilization in this setting.
We retrospectively reviewed consecutive patients treated with stented, distal hypospadias repair from 2011 to 2014 by three surgeons and compared two groups: patients who received preoperative antibiotics and patients who did not. Patients with a history of previous hypospadias repair were excluded from the study.
Two hundred twenty-four subjects were identified. Group 1 (135) received preoperative antibiotic and Group 2 (89) did not receive preoperative antibiotics. There was no statistically significant difference in SSI prevalence with 0 patients in Group 1 and 1 patient in Group 2 having a SSI.
Although prophylactic antibiotics prior to hypospadias repair are most often used by pediatric urologists, this study demonstrates further evidence that antibiotics prior to this procedure do not appear to lower the rate of SSI. This study is limited by its retrospective nature and disparate mean follow up in the two cohorts. Surgical site infection does not appear to be decreased by prophylactic antibiotic therapy before distal hypospadias repair.
手术部位感染（SSI）是任何外科手术都存在的风险，包括尿道下裂修复术。对接受手术的患者进行预防性抗生素治疗通常可有效预防手术部位感染，但随着抗生素耐药率的上升，这种做法受到了质疑。本研究的目的是：1）评估接受带支架远端尿道下裂修复术患者的手术部位感染发生率；2）观察在此情况下，术前使用抗生素和未使用抗生素的患者在手术部位感染发生率上是否存在任何潜在差异。
我们回顾性分析了2011年至2014年由三位外科医生治疗的接受带支架远端尿道下裂修复术的连续患者，并比较了两组：接受术前抗生素治疗的患者和未接受术前抗生素治疗的患者。有尿道下裂修复术史的患者被排除在研究之外。
共确定了224名受试者。第1组（135名）接受了术前抗生素治疗，第2组（89名）未接受术前抗生素治疗。手术部位感染患病率无统计学显著差异，第1组0例患者发生手术部位感染，第2组1例患者发生手术部位感染。
尽管小儿泌尿科医生在尿道下裂修复术前最常使用预防性抗生素，但本研究进一步证明，该手术前使用抗生素似乎并未降低手术部位感染率。本研究受其回顾性性质以及两组队列平均随访时间不同的限制。远端尿道下裂修复术前的预防性抗生素治疗似乎并未降低手术部位感染率。
