Farnell M B, Worthington-Self S, Mucha P, Ilstrup D M, McIlrath D C
Arch Surg. 1986 Jun;121(6):641-8. doi: 10.1001/archsurg.1986.01400060035003.
A preliminary report from our institution suggested that closure of abdominal incisions with subcutaneous, closed-suction catheters intermittently irrigated with antibiotic resulted in decreased wound infection rates. To test this hypothesis, a prospective, randomized, controlled trial was undertaken to compare the results of primary closure, subcutaneous catheter irrigated with saline or antibiotic, and subcutaneous catheter alone. During the two-year trial, 3,282 incisions (type II, III, or IV) were analyzed. Subcutaneous catheter placement alone or with antibiotic or saline irrigation was not superior to primary closure for type II or III incisions. A trend favoring subcutaneous catheter and antibiotic irrigation was observed for type IV incisions. This finding suggests that further clinical trials designed to assess the role of subcutaneous catheter placement and antibiotic irrigation in decreasing wound infection rates are warranted in type IV incisions.
我们机构的一份初步报告表明，使用皮下闭合吸引导管间断用抗生素冲洗来闭合腹部切口可降低伤口感染率。为验证这一假设，我们进行了一项前瞻性、随机、对照试验，以比较一期缝合、皮下导管用生理盐水或抗生素冲洗以及单纯皮下导管的效果。在为期两年的试验中，分析了3282个切口（II型、III型或IV型）。对于II型或III型切口，单纯放置皮下导管或联合抗生素或生理盐水冲洗并不优于一期缝合。对于IV型切口，观察到有倾向于皮下导管和抗生素冲洗的趋势。这一发现表明，有必要针对IV型切口开展进一步的临床试验，以评估皮下导管放置和抗生素冲洗在降低伤口感染率方面的作用。
