Peacock K C, Hanna D P, Kirkpatrick K, Breidenbach W C, Lister G D, Firrell J
Christine M. Kleinert Institute for Hand and Micro Surgery, Louisville, Ky 40202.
J Hand Surg Am. 1988 Nov;13(6):960-4. doi: 10.1016/0363-5023(88)90281-x.
Eighty-seven patients participated in a prospective, double-blind, clinical study to determine the efficacy of preventive antibiotics in the management of common open traumatic hand wounds ranging in severity from single nail bed injuries with open fractures to moderately contaminated wounds involving tendon, bone, joint, and neurovascular structures. Under current medical practice, these wounds would be treated with antibiotics. Thirty-nine patients received intravenous cefamandole and oral cephalexin and 48 received intravenously and orally administered placebo. With an overall infection rate of 1.1%, there were no infections in the antibiotics group and only one (2.1%) infection in the placebo group. Aerobic cultures from 97 similar wounds were 53.6% positive predebridement and 50.5% positive postdebridement. There was no significant difference in rates of infection or imperfect wound healing between the two groups. The preventive antibiotics administered were not necessary in treating these wounds when accompanied by debridement, irrigation, and rapid primary repair in an operating room environment.
87名患者参与了一项前瞻性、双盲临床研究，以确定预防性抗生素在处理常见开放性手部创伤中的疗效，这些创伤严重程度不一，从伴有开放性骨折的单纯甲床损伤到涉及肌腱、骨骼、关节和神经血管结构的中度污染伤口。按照目前的医疗实践，这些伤口会使用抗生素进行治疗。39名患者接受静脉注射头孢孟多和口服头孢氨苄，48名患者接受静脉和口服安慰剂。总体感染率为1.1%，抗生素组无感染病例，安慰剂组仅有1例（2.1%）感染。对97个类似伤口进行的需氧培养显示，清创前阳性率为53.6%，清创后阳性率为50.5%。两组之间的感染率或伤口愈合不佳率无显著差异。在手术室环境中，当对这些伤口进行清创、冲洗和快速一期修复时，使用预防性抗生素并非必要。
