Chiesa-Estomba Carlos Miguel, Ninchritz Elizabeth, González-García Jose Angel, Larruscain-Sarasola Ekhiñe, Sistiaga-Suarez Jon Alexander, Altuna-Mariezcurrena Xabier
1 Otorhinolaryngology-Head & Neck Surgery Department, Hospital Universitario Donostia, San Sebastian, Donosti, Guipuzkoa, Basque Country, Spain.
Ear Nose Throat J. 2019 Jul;98(6):362-365. doi: 10.1177/0145561319853520. Epub 2019 May 28.
Surgical site infection (SSI) is a common complication in surgery. In head and neck surgeries, different rates are reported in the indexed literature. Nowadays, this indiscriminate use of antibiotics is associated with increased cost and risks for patients. Antimicrobial misuse has also contributed to the development of antibiotic-resistant bacteria.
A total of 204 patients were included in this observational retrospective cohort study. The primary outcome of this study was to describe the rate of SSI. Wound infection was considered as SSI and was defined as any cellulitis or pus drainage requiring treatment with antibiotics.
Of all, 127 were included in group A (not antibiotic) and 77 in group B (antibiotic prophylaxis); 109 (53.5%) patients were male, and 97 (47.5%) were female. Four (3.14%) patients developed SSI in group A and 3 (3,89%) developed SSI in group B, being not statistically significant ( = .592). In group A, 2 patients suffered SSI after a submandibular gland resection (SGR), 1 patient after a parotid gland resection (PGR), and another one after a branchial cleft cyst resection. In group B, 1 patient suffered SSI after an SGR and 2 after a PGR. On univariate and multivariate analyses, we did not find any variable associated with the development of SSI.
According to our results, the prophylactic antibiotic in clean, benign head and neck surgery is not necessary. Nevertheless, physicians and surgeons should be aware that severe or even fatal SSIs might be developed, and it needs to be explained to our patient before any surgery.
手术部位感染（SSI）是手术中常见的并发症。在头颈外科手术中，索引文献报道的发生率各不相同。如今，这种抗生素的滥用增加了患者的费用和风险。抗菌药物的误用也导致了抗生素耐药菌的产生。
本观察性回顾性队列研究共纳入204例患者。本研究的主要结果是描述SSI的发生率。伤口感染被视为SSI，定义为任何需要用抗生素治疗的蜂窝织炎或脓性引流。
其中，A组（未使用抗生素）纳入127例，B组（抗生素预防）纳入77例；109例（53.5%）患者为男性，97例（47.5%）为女性。A组4例（3.14%）患者发生SSI，B组3例（3.89%）发生SSI，差异无统计学意义（P = 0.592）。在A组中，2例患者在颌下腺切除（SGR）后发生SSI，1例在腮腺切除（PGR）后发生，另1例在鳃裂囊肿切除后发生。在B组中，1例患者在SGR后发生SSI，2例在PGR后发生。在单因素和多因素分析中，我们未发现任何与SSI发生相关的变量。
根据我们的结果，在清洁的良性头颈外科手术中预防性使用抗生素没有必要。然而，医生和外科医生应意识到可能会发生严重甚至致命的SSI，并且在任何手术前都需要向患者解释。
