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择期日间腹腔镜胆囊切除术后局部应用抗生素预防切口感染。

Topical antibiotics in the prevention of port-site infection after elective day care laparoscopic cholecystectomy.

机构信息

Department of General Surgery, PGIMER, Chandigarh, India.

Department of Anaesthesia and Critical Care, PGIMER, Chandigarh, India.

出版信息

Indian J Pharmacol. 2024 Jan 1;56(1):16-19. doi: 10.4103/ijp.ijp_882_20. Epub 2024 Mar 8.

Abstract

BACKGROUND

Wound-related infections and complications are rare after day care laparoscopic cholecystectomy (LC). They can have a significant adverse impact on the postoperative course after an uneventful elective LC. The use of topical antibiotics over the port site may prevent such complications.

MATERIALS AND METHODS

This trial was conducted from January 2018 to June 2019. Two hundred and fifty patients who met the inclusion and exclusion criteria were included in the study. They were randomized into the topical antibiotic group (Group A, n = 125) and control group (Group B, n = 125). All patients underwent four-port LC. Mupirocin 2% topical antibiotic ointment was applied to all four-port sites in Group A, whereas no topical antibiotic was used in Group B. One dose of prophylactic systemic antibiotics was given to all patients in both groups.

RESULTS

The mean age was 43.22 ± 12.7 years in Group A and 43.44 ± 12.5 years in Group B. The comorbidities and the other variables were comparable between the two groups. The port-site infection (PSI) was observed in one patient in Group A and three patients in Group B, which was statistically nonsignificant (P = 0.622). The mean time of detection of infection was 4.75 ± 1.7 days. All the infections were superficial surgical site infections. Microbiological swabs culture of the infected wounds yielded no growth of bacteria.

CONCLUSION

The PSI after LC is very less. The use of topical antibiotics to prevent PSIs after LC could not be established.

摘要

背景

日间腹腔镜胆囊切除术(LC)后很少发生与伤口相关的感染和并发症。对于无并发症的择期 LC 后,如果发生这些并发症,会对术后病程产生重大的负面影响。在切口部位使用局部抗生素可能会预防此类并发症。

材料与方法

本试验于 2018 年 1 月至 2019 年 6 月进行。符合纳入和排除标准的 250 例患者被纳入研究。他们被随机分为局部抗生素组(A 组,n = 125)和对照组(B 组,n = 125)。所有患者均接受四孔 LC。在 A 组中,所有四个切口部位均使用 2%莫匹罗星局部抗生素软膏,而 B 组则未使用局部抗生素。两组患者均给予一剂预防性全身抗生素。

结果

A 组平均年龄为 43.22 ± 12.7 岁,B 组为 43.44 ± 12.5 岁。两组的合并症和其他变量相似。A 组有 1 例患者和 B 组有 3 例患者发生切口部位感染(PSI),但无统计学意义(P = 0.622)。感染的平均检出时间为 4.75 ± 1.7 天。所有感染均为浅表性手术部位感染。感染伤口的微生物拭子培养未发现细菌生长。

结论

LC 后 PSI 非常少见。使用局部抗生素预防 LC 后 PSI 尚不能得到证实。

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