Matsuda Shingo, Ikawa Fusao, Ohba Hideo, Yoshiyama Michitsura, Hidaka Toshikazu, Kurisu Kaoru, Miyamoto Susumu, Date Isao, Nakase Hiroyuki
Department of Neurosurgery, Shimane Prefectural Central Hospital.
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University.
Neurol Med Chir (Tokyo). 2019 Jun 15;59(6):197-203. doi: 10.2176/nmc.oa.2018-0328. Epub 2019 May 9.
Various guidelines regarding surgical site infection (SSI) have recently been established. However, perioperative management of the wound and use of antibiotics have never been standardized completely in departments of neurosurgery in Japan. This survey investigated current perioperative management and administration of surgical antibiotic prophylaxis (SAP) and compared with guidelines intended to reduce SSI associated with neurosurgery in Japan. Questionnaires were distributed to members of the conference on Neurosurgical Techniques and Tools and the Japan Society of Aesthetic Neurosurgery via internet. The questionnaires asked about methods of perioperative management. A total of 255 members returned answers to the questionnaires. The questionnaires revealed that partial or no removal of the hair and hair shampooing at the day before surgery were performed in 96.1% and 88.1% of each institute following the World Health Organization (WHO) guidelines. Use of SAP at just before, during, and after surgery were 65.0%, 86.2%, and 63.0%, respectively. The postoperative period of use of intravenous SAP prolonged beyond 24 h in 80.0% against the recommendation of WHO. Perioperative management of wounds and use of SAP varies in institutes in Japan and some procedures were far different from the WHO guidelines. Japanese neurosurgeons should notice the prolonged SAP and comply with the WHO guidelines.
最近已经制定了各种关于手术部位感染（SSI）的指南。然而，在日本神经外科部门，伤口的围手术期管理和抗生素的使用从未完全标准化。本调查研究了当前围手术期管理及外科手术抗生素预防（SAP）的应用情况，并与旨在减少日本神经外科相关SSI的指南进行了比较。通过互联网向神经外科技术与工具会议成员及日本美容神经外科学会成员发放了问卷。问卷询问了围手术期管理方法。共有255名成员回复了问卷。问卷显示，各机构分别有96.1%和88.1%遵循世界卫生组织（WHO）指南，在术前一天进行了部分或全部毛发去除及洗头。手术前、手术期间和手术后使用SAP的比例分别为65.0%、86.2%和63.0%。80.0%的机构静脉使用SAP的术后时间超过了24小时，这与WHO的建议相悖。日本各机构在伤口围手术期管理和SAP使用方面存在差异，一些做法与WHO指南有很大不同。日本神经外科医生应注意SAP使用时间延长的问题，并遵守WHO指南。
