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颈面部感染的管理:英国颌面科室当前实践的调查

Management of cervicofacial infections: a survey of current practice in maxillofacial units in the UK.

作者信息

McDonald C, Hennedige A, Henry A, Dawoud B, Kulkarni R, Gilbert K, Kyzas P, Morrison R, McCaul J A

机构信息

Aintree University Hospital, Liverpool.

Manchester Royal Infirmary, Manchester.

出版信息

Br J Oral Maxillofac Surg. 2017 Nov;55(9):940-945. doi: 10.1016/j.bjoms.2017.09.002. Epub 2017 Oct 13.

Abstract

Cervicofacial infections are common emergency presentations to maxillofacial departments in the UK, there is no consensus about their management and, in particular, the role of corticosteroids is not clear. Our aim was to find out the current practice of UK maxillofacial surgeons in managing these infections using a multicentre questionnaire study. The questionnaire was designed, piloted, and revised before distribution, and questions were asked to assess preoperative, operative, and postoperative management. It was distributed to maxillofacial surgeons throughout the UK through the Maxillofacial Research Trainee Collaborative (MTReC) network, and at the 2016 British Association of Oral and Maxillofacial Surgeons (BAOMS) Junior Trainees Group conference. A total of 350 questionnaires were distributed to 17 maxillofacial units. Eighty-six questionnaires were distributed at the BAOMS Junior Trainee conference. An overall response rate of 92% (n=324) was achieved. The results showed that there were important differences in reported practice between and within maxillofacial units in the UK in managing these infections. The antibiotic regimens and use of steroids varied widely. Twenty-three per cent of respondents had to wait over 24hours for access to emergency theatres. However, these results provide no hard evidence for or against the use of corticosteroids in cervicofacial infections.

摘要

颈部面部感染是英国颌面科室常见的急诊病例,对于其治疗尚无共识,尤其是皮质类固醇的作用尚不明确。我们的目的是通过一项多中心问卷调查研究,了解英国颌面外科医生在处理这些感染时的当前做法。问卷在分发前进行了设计、预试验和修订,所提问题用于评估术前、术中及术后的处理情况。问卷通过颌面研究实习医生协作组(MTReC)网络,以及在2016年英国口腔颌面外科医生协会(BAOMS)初级实习医生小组会议上,分发给了全英国的颌面外科医生。总共向17个颌面科室发放了350份问卷。在BAOMS初级实习医生会议上发放了86份问卷。总体回复率为92%(n = 324)。结果显示,在英国,各颌面科室之间以及科室内部在处理这些感染的报告做法上存在重要差异。抗生素治疗方案和类固醇的使用差异很大。23%的受访者必须等待超过24小时才能进入急诊手术室。然而,这些结果并未提供支持或反对在颈部面部感染中使用皮质类固醇的确凿证据。

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