Bull Hosp Jt Dis (2013). 2024 Sep;82(3):167-171.
Shoulder arthroscopy and related complications like deep tissue infections have increased in the last several decades. Practice patterns have shown significant consensus among arthroscopic surgeons supporting intraoperative pre-incision antibiotic usage and against postoperative antibiotic usage. While there is consensus in practice, the absence of robust guidelines for postoperative antibiotic prophylaxis after shoulder arthroscopy warrants further research.
The purpose of this study was to determine the incidence of infection after shoulder arthroscopy in patients treated with or without postoperative prophylactic oral antibiotics.
A retrospective review of shoulder arthroscopies was performed at an outpatient surgery center over a 10-year period. The primary outcome measured was infection following a procedure, initial encounter, or subsequent encounter as defined by International Classification of Disease, Tenth Revision - Clinical Modification (ICD-10 CM) codes T81.4XXA or T814XXD. Incidence of infection was calculated for both cohorts and a chi-squared test was used to determine the statistical significance of betweengroup differences in infection incidence. A priori and post hoc power analyses were performed to determine the sample size required for statistical power and statistical power of the findings given the final study sample size, respectively.
A total of 1,801 patients were included in the study. All patients received intraoperative pre-incision antibiotic prophylaxis. Prophylactic postoperative antibiotics were prescribed to 223 (12.38%) patients for varying durations following shoulder arthroscopy. There were zero cases of infection among patients who received antibiotics. There was one case (0.06%) of infection among the patients who did not receive antibiotics. This difference was not statistically significant (p = 0.71). Power analyses showed that the study was highly powered.
Postoperative prophylactic oral antibiotics did not reduce the risk of infection in patients undergoing shoulder arthroscopy.
在过去几十年中，肩关节镜检查和相关并发症（如深部组织感染）有所增加。实践模式表明，关节镜外科医生之间在支持术中切口前使用抗生素和反对术后使用抗生素方面存在显著共识。尽管实践中有共识，但肩关节镜检查后缺乏强有力的预防用抗生素指南，这仍需要进一步研究。
本研究旨在确定接受或不接受术后预防性口服抗生素治疗的肩关节镜检查患者发生感染的发生率。
对一家门诊手术中心 10 年来的肩关节镜检查进行回顾性研究。主要测量结果为根据国际疾病分类，第十次修订版临床修正（ICD-10 CM）代码 T81.4XXA 或 T814XXD 定义的手术、初次就诊或后续就诊后发生的感染。计算了两个队列的感染发生率，并使用卡方检验确定感染发生率在组间差异的统计学意义。进行了事前和事后功效分析，以确定给定最终研究样本量的统计功效和研究结果的统计功效所需的样本量。
共纳入 1801 例患者。所有患者均接受术中切口前预防性抗生素治疗。223 例（12.38%）患者在肩关节镜检查后接受了不同时间的预防性术后抗生素治疗。接受抗生素治疗的患者无一例发生感染。未接受抗生素治疗的患者中有 1 例（0.06%）发生感染。这一差异无统计学意义（p = 0.71）。功效分析表明，该研究具有很高的功效。
肩关节镜检查后预防性口服抗生素并不能降低感染风险。
