Funahara Madoka, Yanamoto Souichi, Ueda Michihiro, Suzuki Takatsugu, Ota Yoshihide, Nishimaki Fumihiro, Kurita Hiroshi, Yamakawa Nobuhiro, Kirita Tadaaki, Okura Masaya, Mekaru Yasuaki, Arakaki Keiichi, Umeda Masahiro
Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Department of Dentistry and Oral Surgery, Hokkaido Cancer Center, Hokkaido Department of Oral and Maxillofacial Surgery, Division of Surgery, Tokai University School of Medicine, Kanagawa Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Nagano Department of Oral and Maxillofacial Surgery, Nara Medical University, Nara First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Osaka Department of Dentistry and Oral Surgery, Okinawa Prefectural Chubu Hospital, Okinawa, Japan.
Medicine (Baltimore). 2017 Dec;96(48):e8891. doi: 10.1097/MD.0000000000008891.
In a pilot study, we showed that topical administration of a tetracycline could decrease oral bacteria levels for 6 hours in patients who underwent oral cancer surgery combined with tracheotomy and flap reconstruction. This multicenter, randomized control trial aimed to investigate the effectiveness of topical application of tetracycline ointment for prevention of surgical site infection (SSI) associated with major oral cancer surgery.
One hundred seventeen patients who underwent oral cancer resection combined with neck dissection, flap reconstruction, and tracheotomy were divided randomly into an intervention group (n = 56) and a control group (n = 61). The intervention consisted of topical administration of tetracycline ointment on the dorsum of the tongue every 6 hours for 48 hours postoperatively. Factors relating to the occurrence of SSI in both groups were subjected to logistic regression analysis.
SSI occurred in 11 patients (19.6%) in the intervention group and 22 patients (36.1%) in the control group. Multivariate analysis showed that a longer operating time and not receiving topical tetracycline were independent risk factors for development of SSI.
Administration of topical tetracycline for 48 hours postoperatively is an effective way of preventing SSI after oral cancer surgery.
在一项初步研究中，我们发现，对于接受口腔癌手术联合气管切开术及皮瓣重建术的患者，局部应用四环素可使口腔细菌水平在6小时内降低。这项多中心随机对照试验旨在研究局部应用四环素软膏预防与口腔癌大手术相关的手术部位感染（SSI）的有效性。
117例接受口腔癌切除联合颈部淋巴结清扫、皮瓣重建及气管切开术的患者被随机分为干预组（n = 56）和对照组（n = 61）。干预措施为术后每6小时在舌背局部应用四环素软膏，共48小时。对两组中与SSI发生相关的因素进行逻辑回归分析。
干预组有11例患者（19.6%）发生SSI，对照组有22例患者（36.1%）发生SSI。多变量分析显示，手术时间较长和未接受局部四环素治疗是发生SSI的独立危险因素。
术后局部应用四环素48小时是预防口腔癌手术后SSI的有效方法。
