Parker M C, Ashby E C, Nicholls M W, Dowding C H, Brookes J C
Ann R Coll Surg Engl. 1985 Jul;67(4):227-8.
Preoperative mechanical bowel preparation, peroperative topical antiseptic measures, and postoperative antibiotic therapy have all been shown to reduce infection after colorectal surgery. We report the results of a randomised trial of preoperative irrigation with a 10% aqueous solution of povidone-iodine (Betadine) versus water in patients undergoing major resection for large bowel carcinoma. All patients had mechanical bowel preparation, preoperative topical povidone-iodine and per and postoperative antibiotics. Of 22 study patients only one (4.6%) developed abdominal wound infection, whereas in 23 controls nine (39.1%) did so (P less than 0.01). In three of the study patients cultures of swabs taken at operation from the transected bowel ends showed no bacterial growth. Arguably the bacterial population would have been markedly reduced in other patients. These results suggest that povidone-iodine irrigation before large bowel resection reduces wound sepsis.
术前机械性肠道准备、术中局部抗菌措施以及术后抗生素治疗均已被证明可降低结直肠手术后的感染率。我们报告了一项随机试验的结果，该试验比较了在接受大肠腺癌大切除术的患者中，术前用10%聚维酮碘水溶液（碘伏）冲洗与用水冲洗的效果。所有患者均接受了机械性肠道准备、术前局部应用聚维酮碘以及围手术期和术后抗生素治疗。22例研究患者中只有1例（4.6%）发生腹部伤口感染，而23例对照组患者中有9例（39.1%）发生感染（P<0.01）。在3例研究患者中，术中从切断的肠端采集的拭子培养显示无细菌生长。可以说，其他患者的细菌数量也会显著减少。这些结果表明，大肠切除术前用聚维酮碘冲洗可减少伤口感染。
