Department of Plastic Surgery, BG University Hospital Bergmannsheil, Bochum, Germany.
J Surg Oncol. 2020 Dec;122(8):1685-1692. doi: 10.1002/jso.26188. Epub 2020 Aug 26.
The use of antibiotic prophylaxis for soft tissue sarcoma resection varies widely while little evidence on this topic exists. The aim of this study was to determine the impact of antibiotic prophylaxis on the occurrence of wound infections.
A single institutional retrospective cohort study was performed on patients who underwent truncal or extremity soft tissue sarcoma resection. The use of antibiotic prophylaxis was assessed and univariate and multivariate analysis of predictors of wound infections was performed.
Nine hundred and fifty-eight patients could be included. Thirty-two percent of patients had no antibiotic prophylaxis, 44% of patients received single-shot prophylaxis, and 24% of patients received single-shot plus continued antibiotic treatment. Wound infections occurred in 140 patients (15%). Independent risk factors for wound infections upon multivariate analysis were obesity, high American Society of Anesthesiologists (ASA) status, high tumor size and grade, operation time over 120 minutes, and other complications. Antibiotic prophylaxis could not be identified as a protective factor in univariate or multivariate analysis.
A favorable effect of antibiotic prophylaxis on the occurrence of wound infections could not be observed. Although more studies on this subject are needed, our data do not support the general use of antibiotic prophylaxis for soft tissue sarcoma resection.
软组织肉瘤切除术后使用抗生素预防的情况差异很大，而针对这一主题的证据很少。本研究旨在确定抗生素预防对伤口感染发生的影响。
对接受躯干或肢体软组织肉瘤切除术的患者进行了单机构回顾性队列研究。评估了抗生素预防的使用，并对伤口感染的预测因素进行了单因素和多因素分析。
共纳入 958 例患者。32%的患者未接受抗生素预防，44%的患者接受单次预防，24%的患者接受单次预防加持续抗生素治疗。140 例（15%）患者发生伤口感染。多因素分析中，伤口感染的独立危险因素包括肥胖、美国麻醉医师协会（ASA）评分高、肿瘤大小和分级高、手术时间超过 120 分钟以及其他并发症。在单因素或多因素分析中，抗生素预防均不能作为保护因素。
不能观察到抗生素预防对伤口感染发生的有利影响。尽管需要更多关于这一主题的研究，但我们的数据不支持软组织肉瘤切除术后常规使用抗生素预防。
