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择期腹腔镜胆囊切除术术后手术部位感染的危险因素。

RISK FACTORS FOR SURGICAL WOUND INFECTION AFTER ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY.

机构信息

Universidade Federal do Paraná, Departament of Surgery - Curitiba (PR), Brazil.

出版信息

Arq Bras Cir Dig. 2022 Aug 26;35:e1675. doi: 10.1590/0102-672020220002e1675. eCollection 2022.

DOI:10.1590/0102-672020220002e1675
PMID:36043650
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9423715/
Abstract

BACKGROUND

One of the ways to avoid infection after surgical procedures is through antibiotic prophylaxis. This occurs in cholecystectomies with certain risk factors for infection. However, some guidelines suggest the use of antibiotic prophylaxis for all cholecystectomies, although current evidence does not indicate any advantage of this practice in the absence of risk factors.

AIMS

This study aims to evaluate the incidence of wound infection after elective laparoscopic cholecystectomies and the use of antibiotic prophylaxis in these procedures.

METHODS

This is a retrospective study of 439 patients with chronic cholecystitis and cholelithiasis, accounting for different risk factors for wound infection.

RESULTS

There were seven cases of wound infection (1.59%). No antibiotic prophylaxis regimen significantly altered infection rates. There was a statistically significant correlation between wound infection and male patients (p=0.013). No other analyzed risk factor showed a statistical correlation with wound infection.

CONCLUSIONS

The nonuse of antibiotic prophylaxis and other analyzed factors did not present a significant correlation for the increase in the occurrence of wound infection. Studies with a larger sample and a control group without antibiotic prophylaxis are necessary.

摘要

背景

外科手术后避免感染的方法之一是使用抗生素预防。对于某些有感染风险因素的胆囊切除术,会进行这种操作。然而,一些指南建议对所有胆囊切除术使用抗生素预防,尽管目前的证据表明在没有风险因素的情况下,这种做法没有任何优势。

目的

本研究旨在评估择期腹腔镜胆囊切除术术后伤口感染的发生率以及这些手术中抗生素预防的使用情况。

方法

这是一项回顾性研究,共纳入 439 例慢性胆囊炎和胆石症患者,分析了不同的伤口感染风险因素。

结果

共有 7 例(1.59%)发生伤口感染。没有任何抗生素预防方案显著改变感染率。男性患者与伤口感染之间存在统计学显著相关性(p=0.013)。没有其他分析的风险因素与伤口感染有统计学相关性。

结论

未使用抗生素预防和其他分析因素与伤口感染发生率的增加无显著相关性。需要进行更大样本量和无抗生素预防对照组的研究。

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本文引用的文献

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Arq Bras Cir Dig. 2021 Oct 15;34(2):e1600. doi: 10.1590/0102-672020210002e1600. eCollection 2021.
2
WHAT'S NEW IN INFECTION ON SURGICAL SITE AND ANTIBIOTICOPROPHYLAXIS IN SURGERY?手术部位感染与手术抗生素预防的新进展?
Arq Bras Cir Dig. 2021 Jan 25;33(4):e1558. doi: 10.1590/0102-672020200004e1558. eCollection 2021.
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What Should be Done for Perforation of the Gallbladder During Laparoscopic Cholecystectomy: Prophylaxis or Treatment?腹腔镜胆囊切除术时胆囊穿孔应如何处理:预防还是治疗?
J Laparoendosc Adv Surg Tech A. 2021 Jan;31(1):54-60. doi: 10.1089/lap.2020.0322. Epub 2020 Jun 26.
4
Modern Elective Laparoscopic Cholecystectomy Carries Extremely Low Postoperative Infection Risk.现代择期腹腔镜胆囊切除术术后感染风险极低。
J Surg Res. 2020 Feb;246:506-511. doi: 10.1016/j.jss.2019.09.038. Epub 2019 Oct 31.
5
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Int Wound J. 2019 Oct;16(5):1164-1170. doi: 10.1111/iwj.13175. Epub 2019 Aug 8.
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BMJ Open. 2018 Mar 16;8(3):e016666. doi: 10.1136/bmjopen-2017-016666.