Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, P.O. Box 263, 00029 HUS, Helsinki, Finland.
Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Eur Arch Otorhinolaryngol. 2022 Jul;279(7):3449-3458. doi: 10.1007/s00405-021-07113-9. Epub 2021 Oct 15.
One of the most common complications after septoplasty is a postoperative infection. We investigated the number of postoperative infections and unplanned postoperative visits (UPV) in septoplasties with and without additional nasal surgery at our institution and evaluated the role of antibiotic prophylaxis.
We collected data of all consecutive 302 septoplasty or septocolumelloplasty patients operated during the year 2018 at the Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital (Helsinki, Finland). Hospital charts were reviewed to record sociodemographic patient characteristics and clinical parameters regarding surgery and follow-up.
Altogether 239 patients (79.1%) received pre- and/or postoperative prophylactic antibiotics and within this group 3.3% developed a postoperative infection. The infection rate in the non-prophylaxis group of 63 patients was 12.7% (p = 0.007). When all patients who received postoperative antibiotics were excluded, we found that the infection rate in the preoperative prophylaxis group was 3.8%, as opposed to an infection rate of 12.7% in the non-prophylaxis group (p = 0.013). When evaluating septoplasty with additional sinonasal surgery (n = 115) the rate of postoperative infection was 3.3% in the prophylaxis group and 16.7% in the non-prophylaxis group (p = 0.034). These results show a statistically significant stand-alone effect of preoperative prophylactic antibiotics in preventing postoperative infection in septoplasty, especially regarding additional sinonasal surgery.
The use of preoperative antibiotics as a prophylactic measure diminished statistically significantly the rate of infections and UPVs in septoplasty when all postoperative infections, superficial and mild ones included, were taken into account.
鼻中隔成形术后最常见的并发症之一是术后感染。我们调查了我院行鼻中隔成形术或鼻中隔成形术加鼻内手术患者的术后感染和计划外术后就诊（UPV）的数量，并评估了抗生素预防的作用。
我们收集了 2018 年在芬兰赫尔辛基大学医院（Helsinki，芬兰）耳鼻喉科进行的 302 例连续鼻中隔成形术或鼻中隔成形术患者的数据。查阅病历记录患者的社会人口学特征和手术及随访的临床参数。
共有 239 例（79.1%）患者接受了围手术期预防性抗生素治疗，其中 3.3%发生了术后感染。在未预防性应用抗生素的 63 例患者中，感染率为 12.7%（p=0.007）。当排除所有接受术后抗生素治疗的患者后，我们发现术前预防性抗生素组的感染率为 3.8%，而非预防性抗生素组的感染率为 12.7%（p=0.013）。当评估行鼻内手术的鼻中隔成形术（n=115）时，预防性抗生素组的术后感染率为 3.3%，而非预防性抗生素组为 16.7%（p=0.034）。这些结果表明，术前预防性抗生素在预防鼻中隔成形术尤其是附加鼻内手术的术后感染方面具有统计学显著的独立作用。
当所有术后感染，包括浅表性和轻度感染，都被考虑在内时，术前使用抗生素作为预防措施可显著降低鼻中隔成形术的感染率和 UPV 发生率。
